Now that the American Rescue Plan has been passed by Congress, which was directed at addressing the Biden administration’s goals around providing relief related to Covid-19, the focus has shifted to the next major proposal from the White House. This new legislative proposal is known as the American Jobs Plan. In the spirit of keeping you up to date on any changes that could occur relating to long-term care, we want to place a spotlight on a few areas of this legislation.
Relevant proposals from the American Jobs Plan:
- Expand access to long-term care services under Medicaid
- Increase support and wages for home health workers
- Upgrade VA hospitals and federal buildings
The proposed expansion of access to long-term care services under Medicaid would be achieved by an increase to the program for home and community-based services (HCBS) and to the program known as Money Follows the Person, which has the goal of transferring nursing home residents back to the community.
The specifics of Biden’s legislation sets out $400 billion that would be earmarked for this discussed increase in access to home and community based care. To put that number into context, the $400 billion would be achieved by an annual increase in spending of $50 billion annually over the course of 8 years. That number represents a 40% increase in the reported spending by Medicaid on long-term care in 2018 and a 70% increase for the same year’s budget on home and community-based services. Additionally, that first $50 billion would be on top of the one-year increase that was passed earlier this year in the American Rescue Plan which saw a $12 billion dollar contribution to the home and community-based services budget.
The American Jobs Plan calls for increasing support for home health workers based on data that shows one in six of workers in this line of work live in poverty. In support of these policy measures, the administration points to a study from the Washington Center for Equitable Growth to demonstrate that increasing the pay for direct care workers led to a reduction in the number of health violations and number of deaths while also lowering the cost of preventative care.
Another study from researchers at UMass Boston argues that the quality of care patients receive and the productivity of direct care workers increases as the pay of those workers is raised. Their research showed that an increase in pay as proposed under this legislation would lead to fewer staffing shortages, lower turnover, and higher productivity in direct care workers.
The American Jobs Plan also looks for $18 billion to be spent on modernizing hospitals and clinics under the direction of Veterans Affairs. The administration’s proposal points out that the median age of U.S. private sector hospitals is approximately 11 years, while the median age for the network of VA hospitals is 58 years. This section of the proposal aims to bring those VA hospitals up to a standard that contributes to a quality of care our nation’s veterans deserve.
The full array of proposals in the American Jobs Plan covers much more than the scope of this update. And of course, there can be a big difference between what form legislation takes as it is first proposed and what it looks like when it is passed by Congress. However, any mention of changes in the world of long-term care means we want to be alert as a firm to any impacts that could be on the horizon for our clients. You can expect more details from us as we track the passage of any of these proposals into law.
If you or your loved one has questions we would be glad to extend a FREE CONSULT to answer those estate planning and elder law questions and get your affairs in order. Let the experienced attorneys at McIntyre Elder Law help. Call (828) 233-5991.
IN PERSON . VIDEO CONSULT . PHONE CONSULT

Jake Edwards
Estate Planning & Elder Law Attorney
mcelderlaw.com
Hendersonville Office
136 S. King St. Hendersonville, NC 28792
828-233-5991