Senate Finance Committee Democrats want public comments by Dec. 18, 2026 on a plan to create a universal home care benefit, pay the long-term care workforce better and end waiting lists for home care. Ranking Member Ron Wyden (D-Ore.) released the 81-page request for information on Oct. 16, with a committee announcement that describes it as a move toward an affordable home care guarantee.

It is a request for ideas, not a bill. It builds on a May 20 "Dear Colleague" letter from Wyden and 16 other senators, and the document says committee staff have since held more than 95 listening sessions with 180 organizations.

What it asks about home care

The first section asks how a universal benefit for home and community-based services (HCBS) should work: who qualifies based on functional need, what Medicare and Medicaid would each cover, cost-sharing and buy-in options, and how participant direction would fit.

It asks whether to build on the HCBS Access Act, which would make HCBS a mandatory Medicaid benefit and, the RFI says, outlaw capping waiver slots and keeping multi-year waiting lists. That bill's service list includes direct support during hospital stays, respite, crisis services and assisted living. The RFI also asks how federal money could help states move away from capped waivers.

What it asks about the workforce

The workforce section cites turnover of 40% to 60% among HCBS workers and notes that more than half of the 5.1 million people using Medicaid HCBS are people with disabilities under 65. It seeks feedback on:

  • The 80/20 policy in the 2024 Medicaid Access Rule, which requires at least 80% of Medicaid payments for homemaker, home health aide and personal care services to go to direct care worker pay, "and other related approaches."
  • How to use reimbursement rates to raise wages, including whether to set rates by program or by agency, use a payment benchmark, vary rates by region, and pay for differences in skills and experience.
  • Payment incentives to build a home care provider network big enough for a universal benefit.

A separate section covers nursing home quality and staffing.

Why this matters for providers and DSPs

Nothing changes for agencies now. But the questions about rate benchmarks, wage pass-throughs and waiting lists are the same ones I/DD providers argue about in every state budget. Comments from agencies and direct support staff about what rates actually cover, and what it costs to keep staff, are the kind of data the RFI asks for.

How to comment

Send written comments to homecare@finance.senate.gov by Dec. 18, 2026, and name the section or sections you are answering.