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This data note provides new information about waiting lists in Medicaid home care before many of the provisions in the 2025 reconciliation law go into effect. The data come from KFF's 23rd survey of officials administering Medicaid home care programs in all 50 states and DC.
Using data from the 23rd KFF survey of officials administering Medicaid home care programs, this issue brief describes the mechanisms states are currently using to limit Medicaid spending on home care and their plans for adopting new mechanisms in state fiscal year (FY) 2026.
Increased payment rates for Medicaid home care workers are states’ key approach to addressing workforce shortages. This issue brief describes Medicaid payment rates for home care and other workforce supports that are in place in 2025, before the majority of the 2025 reconciliation law provisions start taking effect.
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.
The Senate Finance Committee’s reconciliation language would reduce existing state-directed payments to hospitals and nursing facilities over time until they are at or slightly above Medicare rates. This analysis identifies states that might have to reduce payment rates for hospitals or nursing facilities if the language is passed into law.
The substantial Medicaid savings in the reconciliation bill that has been passed by the House could have major implications for nearly 15,000 federally certified nursing facilities and the 1.2 million people living in them. Nursing facilities provide medical and personal care services for older adults and people with disabilities, and Medicaid covered 44% of long-term institutional care costs in 2023.
In 2025, many issues are at play that could affect Medicaid coverage, financing, and access to care.
Eighty-one percent of nursing facilities would need to hire additional staff to comply with new nursing staff requirements that the Centers for Medicare and Medicaid Services (CMS) proposed earlier this month, according to a new analysis from KFF.
Fewer nursing facility residents and staff are getting COVID-19 vaccines, according to a new KFF analysis of federal data. Only 38% of residents and 15% of staff have received the latest vaccine.
KFF analysis found that over one-fifth of all U.S. COVID-19 deaths occurred in long-term care facilities despite but as of January 14th, 2024, only 38% of residents and 15% of staff were “up-to-date” with their COVID-19 vaccines, which the CDC defines as having received the updated Fall 2023 vaccine. Those rates are lower than uptake was for the 2022 vaccine.
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