Medicaid is a primary source of payment for long-term care services in the United States. In many cases, Medicaid is used to pay for residential care facilities. But many seniors try to stay home as long as possible, relying on home and community-based services instead. As you might expect, funding for home-based services has not risen to meet demand, but this may be changing in the future. The American Jobs Plan proposed in March 2021 hopes to increase the funds needed to provide Medicaid long-term care services to a larger pool of recipients.

The American Jobs Plan

As it now stands, the American Jobs Plan (the “Plan”) is intended to strengthen the economy in several areas by:

  • Improving infrastructure.
  • Promoting housing, schools, and health care.
  • Investing in manufacturing, small business, and job training.

We would need a much longer article to describe the details of each of these components fully. But we are just focused on how the American Jobs Plan will affect the future for Medicaid long-term care beneficiaries.

What the Plan Means for Medicaid Long-Term Care

Under the Plan, federal support for Medicaid home and community-based services (HCBS) would increase by $400 billion over eight years. This translates into a $50 billion annual increase. Medicaid’s share of the budget increases by 40% over 2018 funding. This additional money adds to the $12 billion assigned to Medicaid HCBS in the American Rescue Plan passed earlier this year.

But how will the money be used?

Generally, people hope the new money will improve Medicaid long-term care services by:

  • Reducing wait time for services,
  • Expanding the Money Follows the Person program,
  • Attracting more qualified workers with higher pay and better benefits,
  • Including more hours of care and expanding types of equipment covered by Medicaid,
  • Expanding eligibility for Medicaid long-term care programs like HCBS.

Although the Plan proposals could help, some issues are left unresolved.

The Future Looks a Little Brighter for Medicaid Long-term Care, But There’s Still Room for Improvement

Some feel that the Plan does not go far enough. For example, the Plan proposals for Medicaid focus on HCBS programs. Other programs associated with Medicaid may not receive additional funds.

Critics of the plan say that the needs of young people and older adults with disabilities are still not being met, including the need for Medicaid long-term care.

The provision that increases pay for long-term care workers could reduce services in other areas. In addition, higher labor costs could force some agencies to reduce hours, which then means less comprehensive care for Medicaid recipients.

Finally, many middle-income Americans cannot afford long-term care insurance but do not qualify for Medicaid. One suggestion for further improvement is to develop federally-funded long-term care insurance.

As lawmakers continue to iron out the Plan’s details, Medicaid long-term care beneficiaries – both at home and in nursing facilities – could stand to benefit from increased funding and eligibility expansion.

About the Author

Attorney Robert Slutsky was one of the first lawyers in Pennsylvania to focus on elder law issues, including Medicaid. Since 1992, he has helped countless people find solutions that work for their individual situations.

Please give us a call at (610) 940-0650 or schedule a consultation on our website. We help clients throughout Chester, Delaware, Montgomery, Bucks, and Philadelphia Counties and beyond.

For a listing of skilled nursing and rehabilitation facilities, please check out our Chester County PA Elder Law Directory and Senior Guide online at:

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