The home care fight in Congress

Explain It to Me

Vox Media Podcast Network

Education, Politics, News, Society & Culture

4.4 • 7.9K Ratings

🗓️ 15 October 2021

⏱️ 42 minutes

🔗️ Recording | iTunes | RSS

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Summary

Joe Biden has proposed a landmark $400 billion expansion of funding for home and community-based services (HCBS), the part of Medicaid that funds support services for older adults and people with disabilities living at home rather than in institutions. But with Congress fighting over which of Biden's priorities to cut to appease moderate Democrats, that proposal could be in peril. Mia Ives-Rublee is a longtime disability rights activist who helped organize the Women's March in 2017 and now serves as director of the Disability Justice Initiative at the Center for American Progress. She spoke with Vox's Dylan Matthews about how HCBS works now, and how Democrats' plans for additional funding would change it. References: Biden’s home-based care plan, explained Polling suggests funding for home care is quite popular "How Could $400 Billion New Federal Dollars Change Medicaid Home and Community-Based Services?" The House Energy and Commerce Committee proposal on HCBS Better Care Better Jobs Act state-by-state fact sheet The Urban Institute's report on strengthening long-term care services Investing in Home Care and Early Childhood Educators Has Outsize Impacts on Employment Hosts: Dylan Matthews (@dylanmatt), senior correspondent, Vox Credits: Sofi LaLonde, producer & engineer Libby Nelson, editorial adviser Amber Hall, deputy editorial director of talk podcasts Sign up for The Weeds newsletter each Friday: vox.com/weedsletter Want to support The Weeds? Please consider making a donation to Vox: bit.ly/givepodcasts Learn more about your ad choices. Visit podcastchoices.com/adchoices

Transcript

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0:15.0	Hello and welcome to the weeds. I'm Dylan Matthews. And today we're talking about a huge part of the Democrats spending bill that hasn't gotten the attention it serves. Long term care.
0:39.0	Millions of Americans rely on Medicaid, not just for doctors appointments and medications, but also for long term care.
0:46.4	That can take the form of nursing homes or group homes, but also home care,
0:51.9	where skilled staffers visit and assist with things like getting dressed, making meals, helping you work,
0:59.9	everything that you need to live a full life.
1:02.5	But for years, Medicaid's long term care services have been underfunded and they've been focused on institutions like nursing homes and group homes,
1:10.0	at the expense of home-based options that grant disabled and elderly Americans more independence than their lives.
1:17.2	The result is millions of people are not getting the services they need.
1:20.8	A million of caretakers are doing unpaid work on behalf of loved ones.
1:24.8	Joe Biden has a $400 billion plan that he hopes will help fix this situation.
1:29.8	And disability and elder rights advocates have been pushing hard for a new investment in long term care
1:34.7	as part of Democrats spending bill this year.
1:37.6	Mia Ives-Rubley is long-time disability rights activist, a organizer of the Women's March,
1:42.9	and director of the Disability Justice Initiative at the Center for American Progress.
1:47.3	We ask her to explain how long-term care works now and how we can make it work better.
1:52.0	Mia, thanks so much for joining us.
1:53.9	I am so glad to be here. Thank you for inviting me.
	...

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