Advocacy Action Alert: Congress Must Include Home & Community Based Services In the Budget


Tell Your Members of Congress that Plans for $3.5 Trillion Spending Package Must Include Home & Community Based Services (HCBS)


Medicaid is the largest source of funding for assistance with daily living for people with disabilities. Medicaid Home and community-based services (HCBS) have been grossly underfunded for decades causing long waiting lists and impacting the quality of care. The pandemic has exacerbated these problems.

People with disabilities and older adults have a higher risk of contracting and facing higher risks of complications due to COVID-19. HCBS programs struggled to continue to provide life-sustaining, daily, in-home services in the face of frontline staff shortages with a long history of low wages. These staff shortages and related risks imperil the lives of people with disabilities. Without the immediate and strong leadership of Congress and the Administration, these problems will get worse.

The workforce and earnings losses related to unpaid family caregiving are alarming and well-documented. Investing in HCBS services expansion will enable caregivers to rejoin the workforce as well as stimulate economic growth and job creation. Without the investment in services outlined in the Build Back Better Agenda, family caregivers will have to continue to fill in the huge gaps in the service system.

The temporary 10% increase to the Federal matching rate (FMAP) included in the American Rescue Plan Act is a critical first step to recover and strengthen access to Medicaid HCBS. However, we must build the infrastructure of home and community-based services desperately needed by people with disabilities and older adults now and in the future.

Better Care Better Jobs Act

On June 24, Senator Bob Casey (D-PA) introduced the Better Care Better Jobs Act (S.2210) with 39 co-sponsors. On the same day, Rep. Debbie Dingle (D-MI) introduced a companion bill in the House (H.R. 4231) with 29 co-sponsors. The bill puts into legislative language the vision within President Biden’s American Jobs Plan to provide a historic $400 billion investment into Medicaid home and community-based services (HCBS). (See more details in this fact sheet.)

This week, Senate Democratic leadership announced that they reached an agreement on a $3.5 trillion budget resolution that they will move through the reconciliation process. The outline of the legislative package includes numerous priorities that will support people with disabilities, including the investment in Medicaid home and community-based services (HCBS).

Congress is deciding right now whether to allocate the full $400 Billion for HCBS that is in President Biden’s Build Back Better recovery plan. The full $400 Billion is necessary to ensure HCBS is accessible and equitable.


  • Contact your U.S. Representative/Congressperson & U.S. Senator. To find your U.S. representative/congressperson & senator, visit:
  • Urge them to include and prioritize the $400 billion investment in the infrastructure of Medicaid home and community-based services (HCBS) as you negotiate the current budget reconciliation package. They must not negotiate away this important investment!
  • Provide personal stories about how HCBS helps you, your family, and your state.
  • Dial 202-224-3121 and ask to be connected with your member of Congress.