Strengthen Non-Medicare Home and Community-Based Services

Because Medicare generally does not cover many home and community-based services (HCBS) and long-term services and supports (LTSS), older adults and people with disabilities rely on a constellation of other programs to fully participate in their communities, including Medicaid and the Older American’s Act (OAA). Accordingly—while developing alternative, longer-term LTSS financing solutions—Congress must ensure these programs are up to the task. This includes best positioning Medicaid to serve beneficiaries in the least restrictive, most appropriate setting by expanding the Independence at Home demonstration, reauthorizing the Balancing Incentive Program, and making both the Money Follows the Person program and the HCBS spousal impoverishment protections permanent. At the same time, Congress must adequately fund OAA and other programs that help older adults and people with disabilities maintain their health and independence.