Dingell's Home Care Bills Have Industry Backing. They Still Need Money.

Representative Debbie Dingell reintroduced two bills last week that would reshape home care in America: the Long-Term Care Workforce Support Act and the HCBS Access Act. Together, they'd expand Medicaid home and community-based services, invest in direct care worker wages and training, and establish metrics to evaluate whether people can actually access services they're entitled to. PHI, the national direct care workforce research center, immediately endorsed both — a signal that the industry sees these as structurally sound, not just symbolic.

But endorsements don't fund mandates. LeadingAge's analysis of the HCBS Access Act flagged the central tension: the bill proposes sweeping expansion without fully resolving how the federal government would finance it. States already struggle to maintain their current Medicaid HCBS programs, and new mandates without matching funds risk becoming unfunded promises — the kind that erode trust in the system they're trying to fix.

What makes this round different is the coalition. Representative Schakowsky signed on as cosponsor, broadening support. And the timing aligns with a care workforce crisis impossible to ignore — every policymaker who's heard from a constituent unable to find a home aide knows the status quo isn't working. Whether that urgency translates to appropriations is the only question that matters.