After months of negotiation with members of Congress – including the more moderate members of his own party – President Biden addressed the nation today with a more concrete framework for his $1.75 trillion Build Back Better Act he feels will now satisfy both houses. The framework laid out today, the White House wrote, will help guide the legislative process and language of the bill.
For caregivers of seniors around the United States, the announcement included some key elements that may affect the estimated 53 million unpaid caregivers around the country.
Regarding elder care, the act is calling on an increase in Medicaid funding to provide expanded access to home care for older adults (as well as those with disabilities)—which includes more than 800,000 individuals on waiting lists right now. The proposal also calls for improved benefits for caregivers on the job.
“They’re just looking for an answer—so your parents can keep living independently with dignity. For millions of families in America, this is the most important issue they’re facing. It’s personal.”
The White House wrote the change would be, “the most transformative investment in access to home care in 40 years, when these services were first authorized for Medicaid.” Biden said this change will be especially important for many reasons:
“They’re on a waiting list right now to get home care,” he said. “They need a little help getting around, having their meals made for them occasionally … They want to stay in their homes, but it’s hard. They’re just looking for an answer—so your parents can keep living independently with dignity. For millions of families in America, this is the most important issue they’re facing. It’s personal.”
The large investment in home- and community-based services (HCBS) would allow many seniors and the disabled the option of living in their own homes through assistance with daily living activities. While the allocation for these services was trimmed down from the original proposed $400 billion over the next decade to only $150 billion, experts report the increase would still set the record for the largest boost in the history of these programs. Another goal is to also increase caregiver wages. The especially low current rate has not only created a shortage of skilled caregivers but also forced many into poverty.
The strong support of the American people, Biden said, made this provision a key component of the act:
“Quite frankly, what we found is that this is more popular – or as popular – as anything else we’re proposing. Because the American people understand the need; it’s a matter of dignity and pride for our parents.”

Another possible benefit for older adults is the proposed expansion of Medicare to cover hearing benefits.
“Only 30% of seniors over the age of 70 who could benefit from hearing aids have ever used them,” the White House report states. “The Build Back Better framework will expand Medicare to cover hearing services, so that older Americans can access the affordable care they need.”
Other aspects of the massive proposal include $555 billion for investments in clean energy to address climate change; a record-setting investment in affordable housing; an extension of the Earned Income Tax Credit to an estimated 17 million low-wage workers; and a new tax on the richest Americans through a “surcharge” on the wealthiest 0.02%, along with a change in approach to tax regulations, as the Huffington Post explains:
“A huge chunk of tax revenue would come not from new taxes, but instead from giving the IRS tens of billions in new funding to enforce existing law and close the ‘tax gap,’ the difference between what people owe and what they voluntarily pay. Most of the gap results from business income earned by wealthy households.”
By repealing the rebate rule of the Trump Administration, the new guidelines will undo the “windfall” for the wealthiest, the White House wrote, and instead invest that money in these new programs. Biden emphasized in his address that no person making less than $400,000 a year will see a tax increase.
It’s a plan, Biden said, that will lay the foundation of better days to come for the nation:
“Here’s what I know: We make these investments, and there’ll be no stopping the American people or America. We will own the future.”