President Joe Biden’s push to send $400 billion long-term care services, with an emphasis on home care, will likely be trimmed significantly as lawmakers barter what healthcare initiatives to keep in an overall $3.5 trillion budget proposal. 

Negotiations in the House have trimmed the figure to $190 billion, while the Senate has discussed pushing it as low as $150 billion, according to a report by Politico. Biden administration officials also have told lawmakers that a minimum of between $200 billion and $250 billion is needed simply to clear the list of people waiting for in-home services, the report noted.

Sen. Tammy Duckworth (D-IL) said lawmakers are using the waitlist as a “basis for the numbers we’re demanding.” 

Long-term care providers have said the $400 billion pledge to invest in home- and community-based services could pay huge dividends for the entire long-term care industry, especially nursing homes struggling with workforce challenges.

“We heard that Senate Finance is at $200 billion [in funding], but we’re going to keep pushing,” Mary Kay Henry, president of the Services Employees International Union, told Politico.

“If the number gets too low, services will expand but the workers’ wages won’t go up. That should make the moderates pause,” Henry added. 

A potential vote on the spending bill is expected this week, according to the report.