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'Build Back Better Act' Passed by the House now heads to the U.S. Senate


Following passage by the U.S. House of the budget reconciliation package, better known as the 'Build Back Better Act', the National Association of Counties (NACo) released an in-depth analysis of key provisions included in the package of significance to county governments.


  • Authorizes the Medicaid Reentry Act, a key priority for counties, which would allow incarcerated individuals to receive services covered by Medicaid 30 days prior to their release from jail
  • Permanently extends post-partum Medicaid coverage from 30 days to 12 months, providing additional access to health services for county residents and reducing uncompensated care costs for county health entities
  • Raises the cap on the state and local tax (SALT) deduction from $10,000 to $80,000 and extend this cap through 2030
  • New investments in child care and early learning programs with the opportunity for counties to receive direct funding to expand access, quality and affordability for working families
  • Establishes new Rural Partnership Program, which aims to enhance rural communities’ access to federal community and economic development funding
  • Additional funding to support county efforts in expanding critical nutrition programs aimed at reducing child hunger
  • Short-term extension of the Child Tax Credit, which will significantly reduce childhood poverty and lead to significant savings across county health, child welfare, criminal justice, and anti-poverty systems and services
  • More than $1 billion in new funding to support counties’ efforts to prevent abuse and neglect of older Americans

The bill containing $1.75 trillion in spending over 10 years, passed the House on Friday, November 19, 2021, and now heads to the U.S. Senate for consideration.