Medicaid Policies for Home-and-Community-Based Services

Caregiving is a pressing challenge facing our aging society. Given that institutional care has become prohibitively expensive and people prefer to avoid it, the focus has shifted to home-and-community-based services (HCBS). At the center of this shift is Medicaid, which covers almost half of all spending on formal long-term care and affects the provision of informal care and formal care more generally. Faced with growing demand for care, states have increasingly sought federal waivers to allow for more Medicaid spending on HCBS. This project will assess the effect of the waivers on key stakeholders and, in the process, create a public-use dataset on states’ HCBS policies to help inform decision-making on the scope and generosity of coverage.