New Dynamics for Home Care and HCA Advocacy with Biden Administration, Senate Majority Shift 

Situation Report | January 25, 2021 

The inauguration of President Joseph Biden and a shift in the U.S. Senate leadership — as with any major political transition — will have profound direct and indirect impacts on health care programs, home and community-based services, and the overall direction of HCA’s advocacy at the federal level.  

During his campaign, over the summer, then-candidate Biden specifically mentioned home care — a rarity for any presidential campaign, no matter what the political party. 

“People in nursing homes have been hit especially hard by the coronavirus, shining a bright light on the fact that many would prefer to be in a home or community-based setting,” the Biden campaign said in a statement accompanying a $775 billion plan for expanding access and lowering the cost of caregiving. According to media reports, $400 billion of this plan would be invested in caregiving for older Americans, including Medicaid investments.   

The Biden administration’s new pandemic plan, announced last week, includes a 100-day “masking challenge” for all Americans, an executive order requiring masks and physical distancing on federal properties, re-engagement with the World Health Organization, development of a COVID-19 response coordinator, and other elements related to COVID-19 testing and the supply chain. 

Notably, it, too, mentions home care, proposing to “strengthen home- and community-based services,” among other components.  

With the transition in Washington, HCA also awaits further details on the confirmation process for key cabinet-level and administration positions that have jurisdiction over health care, including the President’s selection of California Attorney General Xavier Becerra to be the next Secretary of the U.S. Department of Health and Human Services (HHS). It remains to be seen what specific ways a Biden presidency will differ in the administration of home and community-based programs at HHS and, specifically, the U.S. Centers for Medicare and Medicaid Services (CMS), an agency within HHS.  

And, as reported in this week’s state budget story for the Situation Report, Governor Cuomo has cited $350 billion in state and local aid that the Biden administration proposes in its relief plan at a time when the state is facing a $15 billion deficit. The Governor’s budget assumes $6 billion in federal aid to New York, and any amount above or below (depending on negotiations at the federal level) would require adjustments to the Governor’s plan, which, even with the aid assumptions, includes tax increases, revenue raisers and cuts.

New York Senator Charles Schumer Leads Senate Majority  

Meanwhile, New York’s senior U.S. Senator, Charles Schumer, has ascended to Senate Majority Leader following the January runoff elections in Georgia. Those elections brought about a 50-to-50 margin in the Senate that favors Democrats due to a tie-breaking vote that is constitutionally granted to Vice President Kamala Harris.  

HCA congratulates Senator Schumer whose office has been very receptive to HCA throughout the years on key advocacy issues for New York’s home and community-based sector. 

While Senator Schumer’s ascendancy to Majority Leader brings broader responsibilities, it also presents new possibilities for HCA and other New York organizations working on behalf of the Senator’s New York constituents to problem-solve and advance key priorities.  

Please look for more information soon as HCA further develops our federal agenda directed at a new administration and Congress.