“The policy is one thing, and so the question is can you support putting it into this?” Casey said.

Manchin’s Communications Director, Sam Runyon, declined to confirm whether Manchin supports the policy, but reiterated Manchin’s concerns about inflation and his commitment to “lower healthcare costs for seniors and working families.”

Advocates were initially hoping for $400 billion, so anything less than $150 billion would be a blow. But anything is better than nothing, said David Grabowski, a health policy professor at Harvard Medical School who specializes in aging research. 

The simple fact that more home health funding is still under discussion is encouraging, he said, considering the issue lacks the political punch of, for example, efforts to allow Medicare to negotiate drug prices directly with manufacturers.

Ageism and ableism are partly to blame, he added, but it’s also due to a misunderstanding that home health funding only affects a small number of the old and disabled. That thinking excludes the impact on the “sandwich generation” — who split their time taking care of both their children and their elderly parents — as well as underpaid workers in long-term care.  

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Reconciliation talks so far quiet on Medicaid expansion – Roll Call