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Private Duty Source | Medicaid, Workforce

House Subcommittee Holds Hearing on LTSS Workforce

November 1, 2023
  • Key workforce issues discussed by policymakers
  • NAHC member delivers important testimony

On Wednesday, October 25th, in the U.S. House of Representatives, the Health Subcommittee of the Energy and Commerce Committee in the House of Representatives held a hearing titled, “Supporting Access to Long-Term Services and Supports: An Examination of the Impacts of Proposed Regulations on Workforce and Access to Care.” The hearing specifically looked at two recent regulations from the Centers for Medicare and Medicaid Services: The Medicaid Access Rule and its 80-20 passthrough provision and the Nursing Home Minimum Staffing Rule.

Subcommittee Chairman Brett Guthrie (R-KY) opened the hearing with discussion of the regulations, noting that “While well-intentioned, these rules are misguided and will ultimately threaten to undermine access to vital services that our most vulnerable rely upon.”

Hearing witnesses included NAHC Member Mary Killough with AccentCare as well as a nursing home operator, a certified nursing aide who works in a nursing home, a consumer advocate, and a former State long-term care director.

Ms. Killough provided a detailed discussion of the 80-20 rule and its likely negative impact on services to individuals, drawing from her experience as both a homecare agency executive as well as time spent in leadership at the Illinois Department on Aging. During the hearing, Committee Republicans expressed significant concerns with both regulations and spent substantial time questioning the impact of and rationale for the 80-20 rule. In contrast, Democrats focused primarily on the Nursing Home Staffing Rule and provided only cursory discussion and support of the 80-20 rule.

NAHC is grateful to Subcommittee Chair Guthrie and Committee Chair Cathy McMorris Rodgers (R-WA) for holding this hearing and listening to providers’ concerns regarding the 80-20 provision. NAHC will continue to work with Congress to demonstrate the challenges with the regulation and to generate support for alternative solutions to address challenges with the Medicaid home care workforce.

Information about the hearing and a recording of the proceedings is available at: