Introduction

Joe Biden has proposed a landmark $400 billion expansion of funding for home and community-based services (HCBS), the part of Medicaid that funds support services for older adults and people with disabilities living at home rather than in institutions. But with Congress fighting over which of Biden's priorities to cut to appease moderate Democrats, that proposal could be in peril.

Mia Ives-Rublee is a longtime disability rights activist who helped organize the Women's March in 2017 and now serves as director of the Disability Justice Initiative at the Center for American Progress. She spoke with Vox's Dylan Matthews about how HCBS works now, and how Democrats' plans for additional funding would change it.

References:

• Biden’s home-based care plan, explained
• Polling suggests funding for home care is quite popular
• "How Could $400 Billion New Federal Dollars Change Medicaid Home and Community-Based Services?"
• The House Energy and Commerce Committee proposal on HCBS
• Better Care Better Jobs Act state-by-state fact sheet
• The Urban Institute's report on strengthening long-term care services
• Investing in Home Care and Early Childhood Educators Has Outsize Impacts on Employment

Hosts:

Dylan Matthews (@dylanmatt), senior correspondent, Vox

Credits:

Sofi LaLonde, producer & engineer

Libby Nelson, editorial adviser

Amber Hall, deputy editorial director of talk podcasts

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