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  • Medicaid Home Care (HCBS) in 2025

    Issue Brief

    This issue brief provides an overview of what Medicaid home care (also known as “home- and community-based services” or HCBS) is, who is covered, and what services were available in 2025.

  • How do Medicaid Home Care Programs Support Family Caregivers?

    Issue Brief

    This issue brief provides new information about family caregivers from KFF’s most recent survey of state Medicaid HCBS programs, including a discussion of paying family caregivers, self-direction, and supports available for family caregivers.

  • States Adopted Changes to Expand Medicaid Eligibility and Streamline Renewal Processes That Will Continue Beyond the Unwinding, Though Challenges Remain

    News Release

    The unwinding of pandemic enrollment protections in Medicaid helped accelerate states’ expansion of eligibility for key groups and adoption of policy and system changes to streamline renewal processes for enrollees, according to findings from a new KFF survey of state Medicaid officials. These changes mean that the return to “routine” operations when the unwinding period ends will not be a return to pre-pandemic operations in many states. The survey examined actions states have taken to…

  • Recent and Anticipated Actions to Reverse Trump Administration Section 1557 Non-Discrimination Rules

    Issue Brief

    The Biden Administration has started taking steps to reverse Trump Administration policy and regulations that significantly narrowed the implementation and administrative enforcement of Section 1557, the Affordable Care Act’s nondiscrimination provision, particularly as the regulations apply to gender identity and sexual orientation. In addition, several lawsuits challenging the regulations, which were initially issued by the Obama Administration and later substantially revised by the Trump Administration, are pending. Section 1557 prohibits discrimination based on race, color,…

  • Combined Federal and State Spending on Medicaid Home and Community-Based Services (HCBS) Totaled $116 billion in FY 2020, Serving Millions of Elderly Adults and People with Disabilities

    News Release

    The federal government and the states together spent a total of $116 billion on Medicaid home and community-based services (HCBS) in FY 2020, serving millions of elderly adults and people with disabilities, a new KFF analysis finds. Medicaid is the nation’s primary payer for such services, which include assistive technology, personal care to help people with bathing or preparing meals, and therapies to help people regain or acquire self-care and independent living skills. There is…

  • Olmstead: I Did It

    Video

    This Kaiser Commission on Medicaid and the Uninsured video segment returns to the plaintiffs of the Olmstead case five years after the landmark U.S. Supreme Court decision. It reports on the impact of the decision for individuals with disabilities and some of the challenges that remain in the implementation of the court ruling.

  • Medicaid Long-Term Services and Supports: Key Considerations for Successful Transitions from Fee-For-Service to Capitated Managed Care Programs

    Issue Brief

    Although relatively few Medicaid beneficiaries are in capitated managed long-term services and supports (LTSS) programs, significant expansion is anticipated as more than half of states are implementing or proposing new programs that would include a transition from fee-for-service (FFS) to capitated managed care in the LTSS delivery system. By definition, these Medicaid beneficiaries need assistance with activities of daily living. Thus poor transitions, particularly those that lead to gaps in services, can have dire consequences.…

  • Medicaid Eligibility for Individuals with Disabilities

    Issue Brief

    This issue paper updates the July 1999 report and provides a general overview of federal Medicaid eligibility policy for the low-income disabled population. This paper focuses on four broad groups of individuals with disabilities: children under 18; adults under 65 who are not living in institutions; adults under 65 who are living in institutions; and adults under 65 who are also eligible for Medicare. In addition, this paper includes the new eligibility options offered under…

  • Individuals With Disabilities and their Experiences with Medicaid Managed Care

    Report

    Today, one out of every four disabled Medicaid beneficiaries receives health care through managed care. This Background Paper provides insights into how Medicaid managed care is working for individuals with disabilities, based on the findings from seven focus groups held in Florida and New Mexico. The key findings show that adults and children with disabilities feel alone in managing their health care and that important components of managed care - coordination and gatekeeping role that…

  • Brief Examines the Olmstead Decision’s Role In Community Integration for People With Disabilities Under Medicaid

    News Release

    As the 15th anniversary of the Supreme Court’s Olmstead decision approaches this month, a new brief from the Kaiser Family Foundation examines the legacy of the landmark civil rights ruling that the institutionalization of people with disabilities is illegal discrimination under the Americans with Disabilities Act. The brief, Olmstead’s Role In Community Integration for People with Disabilities Under Medicaid: 15 Years After the Supreme Court’s Olmstead Decision, revisits the historic case and examines legal developments…