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House Passes the Build Back Better Act

November 19, 2021

The Congressional Budget Office (CBO) completed its full cost analysis earlier than expected, paving the way for passage in the House.

Progress on passing the Build Back Better Act, the legislative vehicle for President Biden’s $1.75 trillion “human infrastructure” framework, has taken a big step forward. On Thursday the CBO released its full cost estimate of the legislation, clearing a key hurdle for House moderates to support the bill. This cleared the way for final passage in the House Friday morning. The Build Back Better Act now heads to the Senate where negotiations around the House’s inclusion of paid family leave, immigration, and clean energy provisions are expected to delay swift passage. It is likely some of these provisions will be removed from the Senate version in order to garner the 50 votes needed for passage. A final vote in the Senate is not expected until mid-to late December.

The $150 billion for home and community-based services remains in the package, but there will likely be changes made as the bill advances through the Senate. Lutheran Services in America will continue to advocate to retain key provisions that would help address the acute direct care workforce shortage and expand access to home and community-based services including:

  • $150 billion to incentivize states to deliver or improve home- and community-based service programs, including through increasing wages and benefits for direct care workers;
  • $1 billion for a grant program funding strategies to recruit and retain direct care workers; and
  • the provisions of the WORK NOW Act to create a $50 billion grant program supporting nonprofits in paying wages and benefits.

 Please join us in this effort through our advocacy alert.


Biden Administration Issues Vaccine Mandates for Workers

Following the release by the Centers for Medicare and Medicaid Services (CMS) and the Occupational Safety and Health Administration (OSHA) of vaccine mandates with a final compliance deadline of January 4, 2022, for facilities governed by the Medicare and Medicaid Conditions of Participation (CoPs) and employers with 100 or more employees, respectively, Lutheran Services in America has published detailed summaries of the mandates and what they mean for members of our network. We encourage you to review both our CMS and OSHA summaries.

It is important to note that the CMS mandate takes precedence over the OSHA mandate: if a given facility meets the eligibility requirements for both, it should follow the CMS mandate.  Also, subsequent to the filing of multiple lawsuits objecting to the OSHA mandate, that rule is under an emergency stay.  Nevertheless, providers subject to that mandate should plan as though it will take full effect and be prepared to meet the first compliance deadline of December 5.  While multiple lawsuits have also been filed against the CMS mandate, no emergency stay or injunction has yet been issued on that rule.

If you have questions about either mandate, please e-mail Josh Dubensky at jdubensky@lutheranservices.org.