The IRA Didn't Include Crucial Funding Needed for the Disabled

For a hot minute there, I allowed myself to feel genuinely optimistic. It seemed like Congress might actually be on the verge of a historic breakthrough.

A lot of disabled people who need this kind of help languish on waiting lists because there isn't nearly enough HCBS funding.

Do you remember way back in 2021, when President Joe Biden released a lofty plan to improve U.S. infrastructure called the American Jobs Plan? That plan included investing $400 billion in building what the American Jobs Plan fact sheet referred to as the "infrastructure of care."

That was extremely important to disabled folks like me who rely on the assistance of others to get through each day. I use a motorized wheelchair and employ different people to come to my home every day. They help me do basic but essential things like getting dressed and out of bed. My assistants are paid via a state program that is largely funded by Medicaid.

This kind of public support is commonly referred to as a home and community-based services (HCBS) program. But a lot of disabled people who need this kind of help languish on waiting lists because there isn't nearly enough HCBS funding. As the American Jobs Plan fact sheet underlined, "Hundreds of thousands of people who need better care are unable to access it, even though they qualify under Medicaid. In fact, it can take years for these individuals to get the services they badly need."

The original House of Representatives Build Back Better bill had contained a lot of the stuff President Biden and the Democrats wanted, including $150 billion for HCBS. But, as you probably know, thanks to the obstructionism of Senate Republicans and a few faux Democrats, the infrastructure bill that finally passed was deeply eviscerated.

Among the elements that were axed was every cent of the HCBS funding.

When Biden signed the Inflation Reduction Act into law on August 16, it was applauded as historic legislation that will rigorously combat climate change, lower the cost of prescription drugs, and address other important things like that.

But it provided no new funding for HCBS. So it's hard for me to get too excited about this law, even if it does accomplish many other things.

I've been involved in enough negotiations to know that you always bring extra demands to the table just so you can keep what you really want. Since Biden and other Democratic leaders were so quick to let new HCBS funding be reduced to zero, it makes me wonder if they were ever serious about it in the first place. Was the HCBS funding included only because they knew it would never pass? Was it just something to throw away? It sure feels like it.

Climate change and the cost of prescription drugs are important issues that demand action. But so is keeping my assistants paid and ensuring that disabled folks across the country can receive the same level of care I have.