September 15, 2021 Advocacy Alert

Call Your Senators & Let Them Know “Care Can’t Wait!”
Raise Your Voice for Home and Community-Based Services

September 15, 2021

The Biden administration has been very vocal in advocating for a $400 billion investment in Medicaid home and community-based services (HCBS) to serve two purposes: to help improve access for older adults and individuals with disabilities and to invest in the care workforce infrastructure that is essential to providing these critical services.

The proposal, as encapsulated in the Better Care Better Jobs Act (BCBJA) introduced in July, recognizes that caregiving is infrastructure—and does so by investing in HCBS, providing better support for family caregivers, better pay for home health workers and getting eligible people off of Medicaid waiting lists. This proposal presents an huge opportunity to reverse the decades-long underinvestment in HCBS for our aging nation. We just need Congress to pass it.

This means your Senators need to hear from you! Democrats are currently negotiating funding for many important priorities in the reconciliation bill, including health care, childcare, support for older Americans and people with disabilities, and more. Unfortunately, only $190 billion for Medicaid HCBS is currently being considered by the Senate—and even that number may be reduced as Democratic leaders negotiate with their moderate members to advance the massive bill. That’s less than half of the President’s and the BCBJA investment level—and not enough to make the sweeping changes needed in Medicaid HCBS and the HCBS workforce!  

Our nation’s older adults need more HCBS options and our country needs a stronger direct care workforce. Urge your Senators to ensure the full $400 billion in funding for BCBJA is included as part of the reconciliation bill, because caregiving IS infrastructure and #CareCantWait!

Here’s How You Can Take Action:

Learn more about the Better Care Better Jobs Act!
The BCBJA represents an historic investment in the lives of millions of older adults, people with disabilities and their families and caregivers. If fully funded at $400 billion, this bill would support Medicaid HCBS for an estimated additional 2.3 million people—reducing and preventing institutionalization. BCBJ authors predict the bill would allow one million informal family caregivers to return to the workforce knowing their loved ones have the care they need, and would create over 500,000 new, better-paying, jobs for direct care workers. More details on BCBJ in this one-pager from its congressional sponsors.

Ask your Senators for their support. While USAging members play a range of roles in their state’s Medicaid HCBS system, our network shares the belief that there is a critical need to rebalance Medicaid, create greater access to services and invest in the direct care workforce to ensure that older adults can age well at home and with the dignity we all deserve. Be sure to share a local story about the importance of HCBS and the direct care workforce in your community.
Note: While there is no Republican support in Congress for the President’s Build Back Better legislative package, it’s still imperative that you communicate with your Republican Senators on how Medicaid HCBS and the challenges of the direct care workforce affect their constituents. Doing so will not only educate them about the needs of older adults and people with disabilities, but it will help you build relationships for these and future advocacy needs!
The Capitol Switchboard (202.224.3121) can connect you to your Senator’s DC offices or you can look up their websites to send emails via
Sample talking points: “Please help older adults, people with disabilities and caregivers in my community by doing what you can to ensure that President Biden’s $400 billion investment in Medicaid home and community-based services—and the workforce that provides those supports—is fully funded. My community desperately needs these services and, when available, they help the older adults we serve stay out of nursing homes, which saves taxpayer dollars and allows people to remain in their homes as they age. It’s critical that these Medicaid home and community-based services and support for the direct care workforce are included in the reconciliation package with full funding. Thank you for your support.”
P.S. The reconciliation bill also includes great news for Older Americans Act programs and services, so see last week’s Legislative Update for details.
Stay tuned for more updates from USAging and, as always, we thank you for your advocacy!

If you have questions or concerns about this Advocacy Alert or USAging’s policy positions, please contact Monica Billger at and Amy Gotwals at

USAging Fact: Learn about your peers’ work—and how it can fit into your agency’s goals! The AIA Awards recognizes successful and innovative programs that USAging members have developed to serve older adults. Get inspiration from our 2023 winners!