It’s called the American Jobs Plan, but the document released by the White House Wednesday is devoted to building infrastructure as much as it is to building jobs.
In it, President Joe Biden calls for everything from repairing roads and bridges to modernizing public transportation and internet access. He even calls on Congress to invest in the “infrastructure of care” for elderly and disabled Americans.
Specifically, Biden asks Congress to devote $400 billion to expanding access to long-term care, whether in the home or in the community.
“These investments will help hundreds of thousands of Americans finally obtain the long-term services and support they need,” the plan states.
Long-term care refers to medical and nonmedical care for people who are unable to perform basic tasks of daily living, like getting dressed and bathing. This type of care can be provided in a person’s home or in settings like assisted living facilities and nursing homes.
Generally, most health insurance plans — including the federal Medicare health insurance program for seniors and people with certain illnesses or disabilities — do not cover costs associated with long-term care.
Biden’s plan for long-term care
The entire American Jobs Plan is long on plans but short on details. So, one can do little more than infer the logistics, at least at this juncture.
This is as specific as the plan released on Wednesday gets about long-term care:
“President Biden’s plan will: Expand access to long-term care services under Medicaid. President Biden believes more people should have the opportunity to receive care at home, in a supportive community, or from a loved one. President Biden’s plan will expand access to home and community-based services (HCBS) and extend the longstanding Money Follows the Person program that supports innovations in the delivery of long-term care.”
Medicaid— not to be confused with Medicare — is another government health insurance program. Whereas Medicare primarily serves people age 65 and older, Medicaid primarily serves people with low incomes.
Unlike Medicare, Medicaid does cover long-term care costs. In fact, Medicaid is the primary insurance payer for long-term care services nationwide, with more than 20% of all Medicaid spending going toward such care, according to the federal Medicaid program.
But as Biden’s official campaign platform noted, some people on Medicaid are on waiting lists — sometimes for years — for what Medicaid refers to as home- and community-based services, or HCBS. Biden’s campaign promises included increasing Medicaid funding so that those on waiting lists could receive the long-term care they need, and eliminating such waiting lists.
The Money Follows the Person program refers to an effort to shift more Medicaid beneficiaries to long-term care services in the community rather than in institutions. Biden’s campaign promises included making this program permanent and devoting more federal funds to it.
What it means for you
The American Jobs Plan is more a list of Biden’s requests for Congress than it is a proclamation of his own intentions. In fact, the document contains 49 variations of the phrase “President Biden is calling on Congress.”
Generally, only Congress can authorize the spending of federal funds for projects like those in the American Jobs Plan — which states that a total of $2 trillion would be needed this decade to carry out the plan.
So, what will come of the president’s plans — including the $400 billion he wants to invest in long-term care — is ultimately in the hands of your elected officials in the U.S. Senate and House of Representatives.