The Biden administration may have failed to convince Congress to double Medicaid spending on home healthcare in 2021, but the funding increase occurred anyway.
An RCI analysis of federal data has found that spending on the program, which pays health aides and family members to act as caregivers for elderly and disabled adults, nearly doubled between 2019 and 2024, to $46.4 billion a year – an amount nearly identical to the $50 billion per year Biden wanted. As a result, American taxpayers paid more than $217 billion for home-based care under the program during that five-year span.
Lacking congressional approval, policymakers simply moved the initiative out of Washington and down to the state Medicaid agencies.
Although the expansion was promoted as a way to reduce reliance on more expensive nursing homes, federal data show that did not happen. Medicaid spending on nursing facilities rose by nearly $5 billion in the same five years, to $46.3 billion. In addition, the sprawling home care program has become the subject of a growing set of fraud probes and prosecutions involving the billing codes at the center of the new spending.
The data suggest that the complex landscape of healthcare offers myriad ways for states and providers to access large amounts of federal funding.
Join the conversation as a VIP Member