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  • End of Pandemic-Era Policies in Medicaid Home- and Community-Based Services Could Challenge Family Caregivers and Enrollees

    News Release

    Family caregivers played a key role in supporting people who used Medicaid home- and community-based services (HCBS) during the COVID pandemic. Many states used new pandemic-era authorities to support and pay family caregivers and maintain services in other ways amid workforce shortages and other challenges. Now, several states are ending payments to family caregivers and unwinding other pandemic-era policies, which could complicate ongoing workforce shortages and create new challenges for enrollees, according to survey of…

  • Analysis Examines Insurance Coverage, Affordability and Access to Home and Community-Based Services for Children with Special Health Care Needs

    News Release

    A new KFF analysis examines key characteristics of children with special health care needs, the affordability and adequacy of their health coverage, and the implications for such children of potential new federal Medicaid money to assist families in caring for them. Medicaid is a significant source of coverage for medical, behavioral health, and long-term services and supports for children with special health care needs, including home and community-based services (HCBS) that they need to live…

  • In Focus Groups, Direct Care Workers and Unpaid Caregivers Describe Low-Wage, Physically-Challenging Work That is Often Mentally Overwhelming and Marked By Uncertainty

    News Release

    In recent focus group interviews, 32 paid direct care workers and unpaid caregivers who assist seniors and people with disabilities with self-care and household activities describe daily work defined by low pay, physical demands and mental stress that has been made worse by the pandemic. KFF conducted the four focus groups in July and August 2021 with 24 direct care workers and eight unpaid caregivers to help provide context for the ongoing debate in Congress…

  • Supplemental Security Income for People with Disabilities: Implications for Medicaid

    Issue Brief

    This issue brief describes key characteristics of SSI enrollees, explains the SSI eligibility criteria and eligibility determination process, and considers the implications of changes in the SSI program for Medicaid, including the effects of the COVID-19 pandemic and resulting economic downturn as well as proposals supported by President Biden that Congress might consider.

  • 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,…

  • State Options to Expand Medicaid HCBS: Examples & Evaluations of Section 1115 Waivers

    Issue Brief

    States are currently developing plans to access an increased federal matching rate (“FMAP”) for Medicaid HCBS spending established in the American Rescue Plan Act (ARPA) of 2021. In the future, states may also be able to access increased HCBS funds proposed in the Biden Administration’s American Jobs Plan and the Better Care Better Jobs Act recently introduced in Congress. This brief highlights examples of Medicaid HCBS policy changes authorized through Section 1115 demonstration waivers in…

  • State Medicaid Home & Community-Based Services (HCBS) Programs Respond to COVID-19: Early Findings from a 50-State Survey

    Issue Brief

    This issue brief presents early findings from the most recent KFF survey of Medicaid HCBS programs in all 50 states and the District of Columbia. It focuses on state policies adopted in response to challenges posed by the pandemic, the pandemic’s impact on Medicaid HCBS enrollees and providers, and states’ initial plans for the new American Rescue Plan Act 10 percentage point temporary increase in federal Medicaid matching funds for HCBS available from April 2021…

  • Direct Care Workforce Shortages Have Worsened in Many States During the Pandemic, Hampering Providers of Home and Community-Based Services

    News Release

    During the pandemic many states have experienced worsening direct care workforce shortages that have affected providers of home- and community-based long-term care services (HCBS), according to early findings of a new KFF survey of Medicaid HCBS programs in all 50 states and the District of Columbia. Most states reported workforce shortages as the pandemic’s primary impact on HCBS provided in an enrollee’s home and in group homes. The pandemic has brought new attention among policymakers…