Secretary Xavier Becerra, America’s top health official, met with leaders in aging, labor and disability to discuss the future of home care funding on Thursday. This meeting was the first of its kind since negotiations over President Joe Biden’s $1.8 trillion Build Back Better economic plan stalled in December, indicating that the administration has not given up work on the big promises it made to disabled people, seniors and the people who care for them.
The majority of paid and unpaid home care is provided by women, and paid caregiving is overwhelmingly provided by women of color, something both Becerra and attendees highlighted during the meeting.
Many advocates close to the issue have expressed concern that the Biden administration might move on from home care after the failure of Build Back Better. Before talks collapsed, Congress was poised to pass $150 billion in home care funding. This meeting helped ameliorate concern that President Joe Biden may have moved on, though the specifics on how or when such funding might be passed — either through Build Back Better or separate legislation — was unclear.
“I think [the meeting] was a very powerful signal [from the Biden administration]. There doesn’t appear to be much movement right now, but there appears to be quite a lot of support for home and community-based services. People are waiting to see what the legislative package is moving ahead,” said Nancy LeaMond, chief advocacy and engagement officer for AARP.
Participants included representatives from heavy hitters like the Service Employees International Union and AARP, as well as smaller but still influential groups like the American Association of People with Disabilities, the National Domestic Workers Alliance, and Justice in Aging.
Peter Berns, CEO of The Arc, a nonprofit representing people with intellectual and developmental disabilities and their families, told The 19th he was “delighted” by the meeting.
“People with intellectual and developmental disabilities and their families across the country are struggling because the workforce shortage is so bad. It is far beyond a crisis,” he said.
The offices of Sen. Bob Casey, a Democrat from Pennsylvania and Rep. Debbie Dingell — longtime supporters of expanding and increasing home care funding and have regular meetings with advocates — organized the meeting. For Dingell, a Michigan Democrat, the issue is personal. She experienced some of the difficulties firsthand while arranging care for her late husband, Rep. John Dingell.
“No one can do their job if their loved ones aren’t cared for — caregiving allows for all other work to be possible,” Dingell told The 19th.
The issue is personal for Becerra too. “My father was fortunate enough to spend the last years of his life at home with our family as his caregivers. I want people in this country to have the same opportunity my father did, the opportunity to live their lives at home in their communities, with the people they love and those who love them the most,” he told The 19th.
Becerra has been taking on a more visible role in recent weeks, according to CNN. The Washington Post reported in January that the White House has been unhappy with his handling of the pandemic. Becerra has started appearing alongside Biden in White House press briefings and had his first substantive meeting with the president since his confirmation took place, CNN reported.
In a statement to The 19th, Becerra still indicated that the ball is largely in Congress’ court.
“COVID-19 has created a national urgency to expand and strengthen our home and community-based services (HCBS) system. And at HHS, we are seizing this opportunity. But the historic investments in the Build Back Better plan, which is currently in Congress, would go much further. We will continue to work with Congress to get this across the finish line for the millions of aging Americans and people with disabilities across the country.”
Since Build Back Better fell apart last year, The 19th reported that talks were moving forward with issues like child care and climate, but the future of home care funding was unknown. If home care advances as part of Biden’s larger economic agenda, its fate likely rests with Sen. Joe Manchin of West Virginia. The Senate is evenly split, and Democrats are aiming to use a once-a-year maneuver called reconciliation to pass a version of Build Back Better that requires a simple majority for passage. Manchin’s objections to the sweeping package in December focused on the proposed extension of an expanded child tax credit. If home care is separated from Build Back Better it would need 60 votes to pass and faces a steep uphill climb in the chamber.
It isn’t clear where Manchin stands on the issue. Advocates who have met with Manchin’s staff say he is open to home care funding, but in September, Axios reported that he had also expressed concern about the price tag.
“My understanding is that they don’t have an issue with the policy,” said Rhonda Richards, a senior legislative representative at AARP. Other advocates, however, expressed concerns that Manchin might be “souring” on home care funding due to concerns about spending and the deficit. Manchin’s office did not respond to a request for comment.