The Politics of Autism includes an extensive discussion of insurance and Medicaid services for adults with intellectual and developmental disabilities. Home and Community-Based Services (HCBS) are particularly important.
A release from Senator Bob Casey:
Today, U.S. Senator Bob Casey (D-PA), Chairman of the U.S. Senate Special Committee on Aging, and Congresswoman Debbie Dingell (D-MI-6) are introducing legislation to expand access to home and community-based services for older adults, people with disabilities, and injured workers, while increasing pay and improving benefits for the caregivers who provide this life-sustaining care. The Better Care Better Jobs Act would enhance Medicaid funding for home care, helping many of the over 650,000 people on waiting lists nationally finally receive care in the setting of their choice, allowing them to stay active in their communities, and live independently. This legislation would also strengthen the caregiving workforce, improve quality of life for families, and boost the economy by creating good-paying jobs to make it possible for families and workers alike to thrive economically.
The COVID-19 pandemic highlighted the urgent need to ensure that all Americans have the option to receive quality, long-term care in the setting that meets their needs and preferences, and the vast majority of Americans prefer to receive such care and support at home. While all states provide coverage for some home care services, there are significant variations and gaps in coverage due to varying eligibility and benefits standards. The home care workforce—a majority of whom are women and people of color—earn a median wage of $13 per hour with few or no benefits while providing life-sustaining care. Roughly 18 percent of these workers live in poverty. This results in exceptionally high annual turnover rates, estimated to be above 60 percent.
The Better Care Better Jobs Act would increase payment rates to promote recruitment and retention of direct care workers, increase wages, and develop and update training opportunities. The legislation would provide support to the Centers for Medicare & Medicaid Services to conduct oversight and encourage innovation to benefit direct care workers and care recipients.
The Senate cosponsors of the Better Care Better Jobs Act are U.S. Senators Bob Casey (D-PA), Ron Wyden (D-OR), Chuck Schumer (D-NY), Patty Murray (D-WA), Tammy Duckworth (D-IL), Sherrod Brown (D-OH), Maggie Hassan (D-NH), Bernie Sanders (I-VT), Raphael Warnock (D-GA), Jeff Merkley (D-OR), Chris Van Hollen (D-MD), Kristen Gillibrand (D-NY), Sheldon Whitehouse (D-RI), Richard Blumenthal (D-CT), John Fetterman (D-PA), Alex Padilla (D-CA), Tim Kaine (D-VA), Dick Durbin (D-IL), Tammy Baldwin (D-WI), Tina Smith (D-MN), Ed Markey (D-MA), Amy Klobuchar (D-MN), Jack Reed (D-RI), Elizabeth Warren (D-MA), Debbie Stabenow (D-MI), Maria Cantwell (D-WA), Ben Cardin (D-MD), Cory Booker (D-NJ), Brian Schatz (D-HI), Angus King (I-ME), Martin Heinrich (D-NM), Mazie Hirono (D-HI), Jeanne Shaheen (D-NH), Peter Welch (D-VT), Chris Murphy (D-CT), Bob Menendez (D-NJ), Ben Ray Luján (D-NM), Dianne Feinstein (D-CA), Catherine Cortez Masto (D-NV), and Gary Peters (D-MI).
Read more about the Better Care Better Jobs Act here.