A new study by Urban Institute researchers found investment in home- and community-based services could significantly expand eligibility for HCBS, increase caregiver wages and increase availability of services.
The analysis, funded by healthcare nonprofit Robert Wood Johnson Foundation, explores three investment policy options ranging from $100 billion to $300 billion in funding over eight years. Among the findings:
- Permanently increasing the federal government’s share of every state’s Medicaid expenditure by 10% could expand HCBS to 360,000 new beneficiaries and increase wages by $5,000 annually for 1.5 million workers at a cost of $104 billion.
- Targeting federal spending within states with below-median HCBS spending could expand the program to 970,000 new beneficiaries and increase wages by $5,800 annually to 400,000 workers at a cost of $196 billion.
- Offering new federal funding to every state by boosting states with low HCBS spending to the national median could expand the program to 1.16 million new beneficiaries and increase wages by $5,000 annually for 1.5 million workers at $317 billion.
“Greater investment in home- and community-based services will help to counteract the institutional bias in the Medicaid program and allow more people to remain in their homes,” Katherine Hempstead, senior policy adviser at the Robert Wood Johnson Foundation, said. “There are many policy options, but successful efforts will require not just additional spending, but also better program design and an investment in the workforce.”
The Biden administration has recommended increasing HCBS spending by $400 billion over eight years. House Democrats are still ironing out details of the administration’s $3.5 trillion budget which includes funding for the nation’s care economy.
