HEALTH CARE BRIEFING: Home Health Care Agenda Hinges on States


November 1, 2021 6:11 am

Democrats’ proposed home health care program has shrank to $150 billion, sparking concern it may not be enough to meet its supporters’ lofty goals.

The plan to expand Medicaid’s home and community-base care services, which help people with disabilities and the elderly remain in their homes and avoid long-term care facilities, once stood at $400 billion. Backers as recently as last week were hoping for $250 billion over the next 10 years.

The trimmed-down proposed investment means the federal government will be able to offer less money to states to entice officials to embark on long-term plans to boost pay for home health workers and cut down their waiting lists for people seeking these services.

“It’s not where we wanted to land,” Sen. Bob Casey (D-Pa.), one of the main sponsors of the home health legislation, said Thursday. “But, it’s a number we can work with.”

The lower price tag was included in the latest version of Democrats’ tax and social spending package (H.R. 5367), released last week. Democrats are still negotiating over some elements of the bill.

Backers of the package in labor unions, who’ve spent months rallying support for it, called a framework released by the White House last week a first-of-its-kind investment in home care.

“This is a commitment to working people, with an historic investment in home care workers and care services,” Mary Kay Henry, international president of the Service Employees International Union, said in a statement. Read more from Alex Ruoff.

Pelosi Leading Talks to Include Drug Price Cuts: Speaker Nancy Pelosi (D-Calif.) is leading an effort to add a plan to cut prescription drug prices to Biden’s $1.75 trillion economic plan, and lawmakers are optimistic a deal can be reached. The emerging plan could allow Medicare to negotiate drug prices for the first time, and talks continue on what categories of drugs would be subject to the cost-cutting negotiation power.

To do that and not lose votes, Democrats will likely have to drop or modify a proposed 95% excise tax on drug companies that was originally proposed to force them to lower prices for younger patients not part of Medicare. The changes to drug prices appear to have a better shot than another liberal priority, paid family leave. But already, leading proponents of that policy are signaling they will not be able to convince Sen. Joe Manchin (D-W.Va.) to go along with it. 

  • Biden left mention of cutting drug prices out of the outline he presented to Congress on Thursday, but even opponents of the original House provision said they would be open to a more limited version. Sen. Kyrsten Sinema (D-Ariz.) had agreed to at least some version of drug price cuts in a deal with the White House, a person familiar with her views said.
  • Rep. Peter Welch (D-Vt.) said Pelosi is “intimately” involved in talks and they are working with drug price provision holdout Rep. Scott Peters (D-Calif.). He said Peters is on track to prevail in his quest to have the 95% tax penalty changed, Erik Wasson reports.
  • “We are working to add things in,” Rep. Ro Khanna (D-Calif.), who backs the effort to curb prescription-drug prices, said on CBS’s “Face the Nation,” yesterday. “I think we can have the vote by Tuesday,” Khanna said.