By NextBestFitPhase 3: Waves 2 & 3: working-age adults · Step 3.2
Make home- and community-based care an entitlement
Year 2 · UHA; state aging & disability agenciesDiscuss this step
Long-term services at home stop depending on Medicaid's poverty rules and capped waivers. HCBS spending goes from $320.5B to $353.5B, home health from $169.4B to $204.5B, and nursing facilities from $219.9B to $225.7B.
Legal vehicle
Universal Health Act, Title III; repeal of Medicaid §1915(c) waiver caps for UHP enrollees.
Who does it
UHA; state aging & disability agencies
When
Year 2
Recurring, per year
+$74.0B
Ledger lines 'Other health, residential & personal care', 'Home health care', and 'Nursing facilities'. Combined change +$74.0B.
In this step
Tasks
5 tasks
Costs & calculations
3 cost items, each with its calculation
Trade-offs
3 pros · 2 cons · 1 trade-offs
Risks
1 risks with mitigations
What changes in the system
2 existing laws, programs, or institutions changed
Other countries
4 comparisons
Cost items
- Other health, residential & personal care$353.5B
- Home health care$204.5B
- Nursing facilities & continuing-care communities$225.7B
Depends on
Steps that depend on this one
None.
Sources: KFF (2024)