Comparison released: November 17, 2023

Community members sought a comparison of the HCBS legislation introduced in the 118th Congress Session (2023-2024). Senator Bob Casey offers the comparison below of the Better Care Better Jobs, the HCBS Access Act, and the HCBS Relief Act.

See the original document here. Please note the original document is not screen reader accessible.

Goal of:

• Better Care Better Jobs: To stabilize HCBS provider networks in states, increase wages for HCBS workers, and encourage provider registries.
• HCBS Access Act: To make HCBS a mandatory Medicaid service in all states with a core set of benefits. Also, to eliminate waiting lists for HCBS and to provide on-going funding for HCBS.
• HCBS Relief Act: To provide short-term funding to states to stabilize HCBS service provider networks and encourage increases in HCBS reimbursement rates.

Estimated Funding for:

• Better Care Better Jobs: $300 billion
• HCBS Access Act: $30-$40 billion per year
• HCBS Relief Act: $30 billion

FMAP Increase:

• Better Care Better Jobs: Up to 12 points
• HCBS Access Act: 10 points
• HCBS Relief Act: 10 points

Time Period:

• Better Care Better Jobs: 10 years
• HCBS Access Act: Permanent
• HCBS Relief Act: 2 years

Self-Directed Care:

• Better Care Better Jobs: State encouraged to expand self-directed care options for HCBS.
• HCBS Access Act: State encouraged to expand self-directed care options for HCBS.
• HCBS Relief Act: State encouraged to expand self-directed care options for HCBS.

Direct Service Workers:

• Better Care Better Jobs: New funds could be used to provide wage increases, bonuses, or other compensation.
• HCBS Access Act: New funds can be used for wage increases; creates a technical assistance center for the direct care workforce.
• HCBS Relief Act: New funds could be used to provide wage increases, bonuses, or other compensation.

Family Caregivers:

• Better Care Better Jobs: Funds available for respite care, training, assistive technology, and other family needs.
• HCBS Access Act: Funds available for respite care, training, assistive technology, and other family needs.
• HCBS Relief Act: Funds available for respite care, training, assistive technology, and other family needs.

Senate Sponsor:

• Better Care Better Jobs: Sen. Bob Casey
• HCBS Access Act: Sen. Bob Casey
• HCBS Relief Act: Sen. Bob Casey

Number of Senate Co-sponsors:

• Better Care Better Jobs: 41
• HCBS Access Act: 19
• HCBS Relief Act: 20

House Sponsor:

• Better Care Better Jobs: Rep. Debbie Dingell
• HCBS Access Act: Rep. Debbie Dingell
• HCBS Relief Act: Rep. Debbie Dingell

Number of House Co-sponsors:

• Better Care Better Jobs: 93
• HCBS Access Act: 5
• HCBS Relief Act: 0

Bill Numbers:

• Better Care Better Jobs: S. 100/ H.R. 547
• HCBS Access Act: S. 762/ H.R. 1493
• HCBS Relief Act: S. 3118/ H.R. 6296