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Independent Living News & Policy from the National Council on Independent Living

Information Alert: NCIL Support for the Better Care Better Jobs Act

Last month, the Better Care Better Jobs Act (PDF), H.R. 4131 / S. 2210, was introduced in Congress. The effort was led by Senator Casey (D-PA), Senate Majority Leader Schumer (D-NY), Senator Wyden (D-OR), Senator Murray (D-WA), Senator Duckworth (D-IL), Senator Hassan (D-NH), and Senator Brown (D-OH) in the Senate, and Congresswoman Dingell (D-MI), Congressman Pallone (D-NJ), Congresswoman Schakowsky (D-IL), and Congresswoman Matsui (D-CA) in the House. NCIL supports this bill’s efforts to transform the long term services and supports (LTSS) landscape.

The Better Care Better Jobs Act (BCBJA) would enact President Biden’s American Jobs Plan. The Jobs Plan proposes to spend $400 billion to expand access to home and community based supports and services. The Jobs Plan would invest in the direct support workforce. The BCBJA provides a way to put that plan into motion. The BCBJA would provide states with opportunities to receive enhanced funding to improve their Home and Community Based Services (HCBS) systems.

To receive funding, states must conduct specific activities, including (but not limited to):

  • addressing barriers to accessing HCBS;
  • expanding eligibility to federal limits;
  • providing support to family caregivers;
  • expanding eligibility and / or improving coverage under Medicaid buy-in; and
  • supporting self-direction.

The BCBJA would give states several years to look at their existing HCBS systems and make plans to improve the systems in these areas.

The BCBJA also includes provisions to support direct support workers. Direct support workers have faced disproportionate harm during the pandemic. A majority of direct support workers are women of color. States would be required to strengthen and expand the workforce, including boosting wages, benefits, and opportunities.

The BCBJA would also permanently extend the federal Money Follows the Person (MFP) program and HCBS Spousal Impoverishment Protections. MFP has supported thousands of people in moving out of institutions and into their own homes. Spousal impoverishment protections allow families to keep resources if a spouse uses a state program to get long term services and supports.

The disability community has been calling for an investment in community based services and an end to the institutional bias for decades. The Better Care Better Jobs Act is an important step in this direction. The Better Care Better Jobs Act could improve the lives of millions of disabled people. NCIL is excited to work with Congress to strengthen the bill and to ensure its passage so more disabled people can get the supports and services we need in our own homes and live independent, self-determined lives.


  1. Both myself and my husband are on disability as well as my mother. My husband is bedridden with extensive health issues, even with both my condition and my mom’s we provide care for my husband, we have equipment for lifting and transferring him but our insurance doesn’t provide any respite care and pays only a percentage for most of his needs leaving me in debt without resources to pay these debts. More complete coverage in areas of respite care and basic needs would be a wonderful addition.
    Also my son who has many many health issues cannot get insurance because he can’t work so he doesn’t qualify for Medicaid or insurance tax credit because he has no income therefore we are watching him die because doctors are refusing to see him because of his and our in ability to pay and he can’t get disability because if lack of recent medical care. This is an issue that definitely needs addressed.