October 14, 2021

President Joseph R. Biden, Jr. The Honorable Charles Schumer

The White House Majority Leader
1600 Pennsylvania Avenue NW United States Senate
Washington, D.C. 20500 Washington, D.C. 20510

The Honorable Nancy Pelosi

Speaker
United States House of Representatives
Washington, D.C. 20515

Dear President Biden, Speaker Pelosi and Senate Majority Leader Schumer:

As Members of the House Democratic Caucus Task Force on Aging and Families, we are
thankful for your dedicated leadership and sincere commitment to addressing the public health
and economic crises faced by the American people during the COVID-19 pandemic. As we
move forward in our collective efforts to Build Back Better For the People, our Task Force is
committed to ensuring that we meaningfully impact the lives and wellbeing of seniors and their
families. Therefore, we urge the inclusion of significant investment in Medicaid home and
community-based services, Medicare negotiation to lower prescription drug prices and paid
family and medical leave in the Build Back Better Act.

Significant investment in Home and Community-Based Services (HCBS) will transform our
nation’s caregiving system by expanding access to quality, affordable long-term care for seniors
and people with disabilities. The Task Force was enthusiastic about President Biden’s historic
proposal to invest $400 billion to address the caregiving crisis that has plagued seniors, families
and direct care workers even before the COVID-19 pandemic began. As discussions for the
Build Back Better Act continue, we urge you to include the highest possible level of funding for
Medicaid home and community-based services. Only then will we be able to fully address the
nearly 800,000 Americans on waitlists for care and the 40 percent of care workers forced to rely
on public assistance due to low wages. Robust funding for HCBS will transform these low-paid
care worker jobs, which are overwhelmingly held by women of color, into sustainable
employment with vital benefits and protections. These labor improvements for the direct care
workforce are vastly overdue, and it is imperative to invest in and care for those who are caring
for us, especially considering the risks undertaken during the pandemic. It is evident that the
current patchwork of underfunded Medicaid programs is not equipped to address our ongoing
caregiving crisis. Only through significant federal investment will our seniors, people with
disabilities and caregivers be able to live with dignity in their communities.
Medicare negotiation to lower prescription drug prices will greatly benefit our seniors and
families, who pay on average three or four times more for the same drugs compared to other
developed countries. For decades, Americans have disproportionately borne the brunt of high
prescription costs. Therefore, we urge the inclusion of expansive and effective negotiation
authorities within the Medicare program. Additionally, lowering the costs of life-saving
medications will produce substantial savings for our critical efforts to expand Medicaid
coverage, invest in dental, vision and hearing services under Medicare and improve maternal
health outcomes for vulnerable populations.

Paid Family and Medical Leave is long overdue, as the United States remains the only
industrialized nation without such comprehensive standards. As the demographics of our society
change and our economy continues to recover, it is vital that families can take the time to care
for loved ones or recover from illnesses without jeopardizing their financial security. The Task
Force looks forward to the life-changing relief that will be offered to millions of families when
all American workers are provided up to twelve weeks of universal paid leave.

The Build Back Better Act is a once-in-a-generation opportunity to enact transformative change
in the lives of everyday Americans. It is essential that the needs of our seniors, families and
caregivers are centered in these efforts. On behalf of the Task Force on Aging and Families, we
stand ready to work with you as strong partners in supporting these critical priorities to benefit
communities across this nation.

Sincerely,

Rep. Jan Schakowsky Rep. Doris Matsui

Co-Chair, Task Force on Aging and Families Co-Chair, Task Force on Aging and Families

Rep. Conor Lamb Rep. Debbie Dingell

Co-Chair, Task Force on Aging and Families Vice-Chair, Task Force on Aging and Families

Rep. Ayanna Pressley Rep. Ted Deutch

Vice-Chair, Task Force on Aging and Families Vice-Chair, Task Force on Aging and Families