Policy Corner: October 29, 2021

President Releases Build Back Better Framework

After meeting with Democratic leadership and the Progressive Caucus this week, President Biden announced a $1.75 trillion framework for the Build Back Better reconciliation package to pump funding into what is dubbed as the “human infrastructure” bill. The framework includes universal pre-school and child care subsidies, expanded home care for seniors and people with disabilities, and an extension of the child tax credit through 2021. It also would expand Medicare to cover hearing benefits, extend Medicaid coverage to 4 million and reduce premiums in the Affordable Care Act. The $1.75 trillion package left out some priorities that had been targeted such as free community college, dental benefits for Medicare, and paid family leave. Specifically, the pared-down bill includes:

• $150 billion for Medicaid Home and Community-based Services (HCBS), referred to as home care.
• Universal pre-school for all 3- and 4-year olds with funding for six years.
• Affordable child care to expand access to 20 million children for parents who are working, seeking work, in training, or taking care of a serious health issues.

Read the text for the Build Back Better proposal and the statement released by the White House.

It is still unclear whether all Democrats are on board to pass this package.

CMS Launches Webpage on State HCBS Spending Plans

The Centers for Medicare & Medicaid Services (CMS) launched a new “one-stop shop” for state Medicaid agencies and stakeholders on Medicaid.gov to advance transparency and innovation for Medicaid home and community-based services (HCBS) for individuals with disabilities or for older adults. CMS encourages stakeholders and state administrators to visit Medicaid.gov to view states’ programs and activities. The site includes information on states’ spending plans for the enhanced federal match – Federal Medical Assistance Percentages (FMAP) – in accordance with the American Rescue Plan.

CMS has received HCBS spending plans from 50 states and the District of Columbia. Forty-eight states have been fully approved to claim the HCBS FMAP increase retroactively to April 1, 2021, and to begin implementing activities in their spending plans and narratives. Additional information has been requested from three states. States are using the enhanced federal match to support provider increases; to expand services to new populations, such as brain injury; and to recruit and to retain direct care workers. The spending plans also include information about how the state involved stakeholder engagement with regard to the priorities for the increased funding. About half of the states administer separate brain injury HCBS waiver programs. Click here to learn more about the spending plan.

BIAA gratefully acknowledges the Centre for Neuro Skills and Avanir Pharmaceuticals for their support for legislative action. Click here to read past issues of Policy Corner.