Medicaid Home Care (HCBS) in 2025
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 independent source for health policy research, polling, and news.
KFF’s policy research provides facts and analysis on a wide range of policy issues and public programs.
KFF designs, conducts and analyzes original public opinion and survey research on Americans’ attitudes, knowledge, and experiences with the health care system to help amplify the public’s voice in major national debates.
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the organization’s core operating programs.
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.
Medicaid home care programs offer various supports to family caregivers such as paid caregiving, self-directed services, respite care, and caregiver training. This issue brief describes the availability of self-directed services and supports for family caregivers in Medicaid home care in 2025, before most provisions in the reconciliation law take effect.
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 data note discusses the impact of the 2025 reconciliation law on nursing facilities and examines the characteristics of nursing facilities and the people living in them with data from Nursing Home Compare, a publicly available dataset.
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.
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.
To provide historical context for how changes to Medicaid spending may impact national health spending trends, this brief explores how Medicaid spending contributes to national health spending and how different service areas contribute to Medicaid costs.
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.
© 2026 KFF