Schakowsky, Dingell Introduce Legislation to Expand Home Care, Strengthen Care Workforce

WASHINGTON - U.S. Representatives Jan Schakowsky (IL-09) and Debbie Dingell (MI-06) on Wednesday introduced the Home and Community-Based Services (HCBS) Access Act, legislation to expand access to home and community-based care for older adults and people with disabilities while strengthening the caregiving workforce nationwide.

"Older adults and people with disabilities deserve to live with dignity and age in place. Yet the United States still lacks a comprehensive long-term care policy that meets the needs of our most vulnerable communities. Medicaid Home- and Community-Based Services help fill this gap, ensuring millions of Americans can remain independent in their homes and communities," said Congresswoman Jan Schakowsky. "I am proud to join my colleague Congresswoman Dingell in introducing this legislation to strengthen our nation's care infrastructure by expanding access to Medicaid home care, investing in the direct care workforce, and supporting family caregivers. It's time to move beyond discussion and deliver real national solutions to the caregiving crisis."

"We know that the majority of individuals who require long-term care would prefer to receive it in their own homes and communities. No one should have to wait years to get the care they deserve, and no care worker should have to live below the poverty line to give this care," said Congresswoman Debbie Dingell. "Medicaid is the single largest payer of long-term care in our country. At a time when Medicaid is facing unprecedented, historic cuts, it's more important than ever that we prioritize home and community-based services. This legislation will provide much-needed investment in our care workforce, making it easier for those who need care to get it, and supporting the caregivers doing this crucial work."

Medicaid is the primary payer for long-term services and supports (LTSS) in the United States. While eligible individuals are guaranteed access to institutional care, access to home and community-based services (HCBS) often depends on state waiver programs, leaving many individuals on waiting lists for years or even decades.

As a result, many older adults and people with disabilities are forced into institutional settings in order to receive care, even though most would prefer to remain in their homes and communities. This disparity undermines the rights affirmed in the Olmstead v. L.C. decision, which recognized the right of individuals with disabilities to receive services in the most integrated setting appropriate.

The HCBS Access Act would ensure eligible individuals have a real choice between home-based and institutional care by putting both options on equal footing. The legislation would increase Medicaid funding for HCBS, strengthen the federal match to help states expand services, and eliminate waiting lists over time. It also invests in the direct care workforce by improving wages, benefits, and job quality, while providing training and support for family caregivers and establishing stronger quality and accountability measures.

The legislation is endorsed by the American Federation of State, County and Municipal Employees (ASFCME), Justice in Aging, the National Health Law Program (NHeLP), the Service Employees International Union (SEIU), Little Lobbyists, Partnership for Inclusive Disaster Strategies, Partnership for Inclusive Disaster Strategies, American Network of Community Options and Resources (ANCOR), ADAPT, and PHI.

###