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Senate Finance Committee Democrats published an 81-page request for information on Oct. 16 seeking input on home care and long-term care benefits in Medicare and Medicaid. The RFI follows the August introduction of the Medicare At Home Act, but it is a request for public input, not an enacted benefit or a final policy proposal.
Senate Finance Committee Democrats published an 81-page request for information on Oct. 16 seeking recommendations on home care and long-term care benefits in Medicare and Medicaid. The request opens a discussion about how a potential benefit could be designed and delivered; it does not establish new Medicare coverage or confirm that Congress will pass legislation.
The RFI asks how a universal home care benefit might work across Medicare and Medicaid, what services it could include, and how it could connect with provider networks and the existing health care system. It also examines expanding long-term care access, addressing caregiver workforce shortages, and making eligibility and services more consistent across the country.
The request follows the Medicare At Home Act, introduced in August. The proposed bill would add a home care benefit to Medicare Part B, including assistance with activities of daily living and instrumental activities such as meal preparation and light housekeeping. The RFI is a separate step: lawmakers are asking for information and recommendations, rather than announcing that the bill has advanced or that its provisions are settled.
Industry groups said they plan to contribute. The National Alliance for Care at Home intends to submit comments, while the Home Care Association of America said it would share member experience and practical recommendations. Their support reflects the views of provider organizations; it does not establish that a new benefit is funded, finalized or supported by all stakeholders.
Designing Coverage Around Home Care
The discussion could affect how older adults and people with care needs access help at home, including support with daily routines that may otherwise fall to relatives or unpaid caregivers. Whether that support becomes a Medicare benefit would depend on future policy decisions, legislative action and the details of any coverage rules.
The RFI also puts workforce capacity and provider sustainability into the policy discussion. HCAOA CEO Jason Lee said expanded coverage would require more capacity and argued that a benefit should account for caregiver wages, training, benefits and compensation. Those considerations matter because coverage on paper would not by itself create enough workers or providers to deliver services in every community.
There are implementation and oversight questions as well. Lee called for protections for small, community-based providers, care coordination and safeguards against fraud and abuse. These are stakeholder recommendations, not confirmed features of a proposed federal benefit. The RFI gives lawmakers a way to gather views on those trade-offs before deciding what, if anything, to pursue.
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From August Bill to October RFI
The Medicare At Home Act was introduced in August to add home care services to Medicare Part B. The proposal described in the source report includes assistance with activities of daily living and instrumental activities, including meal preparation and light housekeeping. Providers and advocates have voiced support since its introduction, but the supplied reporting does not establish the bill’s legislative status beyond its introduction.
The Oct. 16 RFI broadens the conversation beyond that bill by seeking input on home care and long-term care policy across Medicare and Medicaid. It raises questions about benefit scope, eligibility, delivery through provider networks and the capacity of the workforce. The National Alliance for Care at Home represents a network of more than 2 million professionals across home health, Medicaid home- and community-based services, hospice, palliative care and other home care fields. HCAOA represents more than 5,000 home care agencies, according to the report.
“This RFI raises important questions about strategies to make services more affordable and accessible, strengthen the caregiving workforce and give individuals and families meaningful choices about how and where they receive care.”
— Jason Lee, CEO of the Home Care Association of America
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Coverage Details Remain Open
The RFI does not settle which services would qualify, who would be eligible, how a benefit would be paid for, or how it would operate alongside existing Medicare and Medicaid services. The source report does not specify a response deadline, the total number of comments expected, or when lawmakers might decide on next steps.
It is also unclear whether the Medicare At Home Act will advance, whether any eventual legislation would follow its proposed scope, or whether lawmakers would pursue a benefit through Medicare, Medicaid, or both. Workforce supply, provider participation, costs and safeguards remain questions for the policy process, not confirmed outcomes.
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Comments and Legislative Decisions
The next step is for stakeholders to respond to the RFI. The National Alliance for Care at Home said it plans to submit comments, and HCAOA said it looks forward to contributing recommendations from its members. The source report does not give a deadline for submissions.
After gathering input, lawmakers could use responses to shape future proposals or refine the debate around the Medicare At Home Act. Any new federal benefit would still require policy and legislative decisions, and the available information does not indicate when a bill might receive further consideration. Readers should watch for the RFI’s submission schedule, published responses and any formal legislative action.
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Key Questions
What is the 81-page RFI?
It is a request for information published by Senate Finance Committee Democrats on Oct. 16. It asks for input on possible home care and long-term care benefits involving Medicare and Medicaid; it does not itself create coverage.
Does the RFI mean Medicare home care is now covered?
No. The RFI is a request for policy input, not a new Medicare benefit. The source report does not say that Congress has enacted expanded home care coverage.
What would the Medicare At Home Act cover?
As described in the report, the bill introduced in August would add Medicare Part B assistance with activities of daily living and instrumental activities, including meal preparation and light housekeeping. Its status and eventual provisions are not established by the RFI announcement.
What issues are lawmakers asking about?
The RFI asks about benefit design, provider networks, eligibility, nationwide consistency, workforce shortages and ways to expand home and long-term care. It also raises how services could fit within the existing health care system.
What happens after the RFI?
Stakeholders can provide recommendations, including the two provider groups that said they plan to participate. The report gives no submission deadline or schedule for lawmakers’ decisions, so the timing and shape of any next proposal remain unclear.
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