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New Biden Plan Would Boost Home Care, Transportation, Broadband

$2 trillion proposal includes help for older Americans to remain at home

An in home care worker showing medications to a woman as she eats at her kitchen table

Maskot/Getty Images

En español | It would be easier for older Americans to keep living at home, better afford high-speed internet connections, and have safer and more accessible streets and transit systems in their communities under a $2 trillion infrastructure proposal President Joe Biden unveiled on March 31.

"The American Jobs Plan is an investment in America that will create millions of good jobs, rebuild our country's infrastructure, and position the United States to out-compete China,” the administration says in a fact sheet that outlines its transportation, climate, energy, housing and other infrastructure plans. Biden called it a “once-in-a-generation investment in America,” during a speech in Pittsburgh in which he outlined the proposal.

Home and community-based services

"Even before COVID-19, our country was in the midst of a caregiving crisis,” the plan says. “Hundreds of thousands of people who need better care are unable to access it, even though they qualify under Medicaid.”

The package would:

  • Spend $400 billion to expand access to quality, affordable home or community-based care.
  • Extend the Money Follows the Person program that helps people in nursing homes and other institutions transition back to living at home or in the community. “AARP has long fought for more options and greater access to services to help older adults live in their homes and communities,” said Rhonda Richards, AARP senior legislative representative for health and family.
  • Reduce the waitlist for people who need home- and community-based care by expanding access. “Medicaid does not cover home and community-based services the way it covers nursing home care,” Richards said, “so there are more limited options for the vast majority of older adults who want to live in their homes and communities.” The level of investment in care available at home and in the community varies by state, and there may be waiting lists for that care.
  • Improve the wages and quality of life for essential home care workers. “The pandemic has put a spotlight on the importance of the workforce providing these services,” Richards said. “We've urged Congress to address the long-term care workforce."

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Expand broadband accessibility

The plan calls broadband internet service the “new electricity” and says more than 30 million Americans live in areas where there is no broadband infrastructure that provides minimally acceptable speeds everywhere.

"High-speed internet access helps older adults age in place safely. It helps them overcome social isolation, benefit from telehealth, participate in civic engagement and look for employment,” said Dawit Kahsai, AARP senior legislative representative for economics and consumer affairs. “That's why AARP has encouraged federal and state lawmakers to increase funding for broadband infrastructure, including advocating for additional appropriations in coronavirus relief bills.”

Biden's plan would:

  • Invest $100 billion to build high-speed broadband service in unserved and underserved areas in order to achieve 100 percent coverage.
  • Promote broadband price transparency by requiring internet providers to clearly disclose the prices they charge.
  • Encourage competition by removing barriers that prevent municipally owned or rural electric co-ops from competing with private providers.

More mobile, livable communities

More than 20 percent of people 65 and older — nearly 8 million Americans — do not drive. Adults 65 and older account for 21 percent of all pedestrian fatalities but only 16 percent of the nation's population.

"We have long advocated for mobility options for older adults, including transit and walking and biking,” said Debra Alvarez, AARP senior legislative representative for financial security and consumer issues.

"Older adults consistently tell AARP that it is important for them to be able to stay in their homes and communities as they age, and say they would walk, bicycle and take public transportation more if it were safer for them to do so.”

The administration plan would spend:

  • $20 billion to improve road safety for all, including increases to existing safety programs and a new Safe Streets for All program to fund state and local improvements in order to reduce crashes and fatalities, especially for cyclists and pedestrians.
  • $85 billion to modernize and repair existing transit systems and to help agencies expand their bus and rail systems to meet rider demand.

Dena Bunis covers Medicare, health care, health policy and Congress. She also writes the Medicare Made Easy column. An award-winning journalist, Bunis spent decades working for metropolitan daily newspapers, including as Washington bureau chief for The Orange County Register and as a health policy and workplace writer for Newsday.

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