NewsThe HillMay 6, 2026United States
Proposed Federal Legislation to Expand Home-Based Care and Support Caregivers
This article advocates for two proposed federal bills, the Home and Community-Based Services Access Act and the Long-Term Care Workforce Support Act, which aim to reform Medicaid coverage for home care and improve conditions for direct care workers. The authors argue that current federal policy fails to meet the needs of an aging population, leaving over 600,000 people on waiting lists for home-based services.
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If passed, these bills would convert from optional Medicaid benefits into guaranteed ones, potentially eliminating waiting lists and mandating wage increases for .
Key Facts
- Medicaid currently treats nursing home care as a guaranteed benefit, while home and community-based services are optional for states.
- There are currently over 600,000 people nationwide on waiting lists for home-based care services.
- Medicaid funds 70 percent of all home and community-based care in the United States.
- The Home and Community-Based Services Access Act proposes making home-based care a guaranteed Medicaid benefit.
- The Home and Community-Based Services Access Act aims to eliminate existing waiting lists for home care services.
- The Long-Term Care Workforce Support Act proposes increasing wages and improving training pathways for direct care workers.
- The Long-Term Care Workforce Support Act includes provisions to ensure funding increases are directed toward worker wages rather than administrative overhead.
- The U.S. population over age 85 is projected to more than double by 2040.
- Life expectancy in the U.S. has increased from 61 years in 1935 to 79 years in 2024.