HCBS Access Act

Key Points

• This bill makes home and community-based services a mandatory Medicaid benefit instead of an optional one. Today, states can cap these services and keep long waiting lists, which pushes some people into nursing homes. The bill aims to end those waiting lists and guarantee care for anyone who qualifies.
• The federal government would pay 100 percent of the cost of home care services in states that meet the requirements. To get that full funding, states must remove access barriers, support family caregivers, and pay direct care workers rates high enough to recruit and keep them.
• The bill creates $1 billion in grants plus a national technical assistance center to recruit, train, and advance direct care workers such as home health aides and personal care attendants. It also funds support and training for the millions of family members who provide unpaid care.
• The bill ends Medicaid estate recovery and withdraws existing liens on the homes of people who received care. States must withdraw those liens within 90 days and notify affected families.
• Most of the major changes take effect five years after the bill becomes law, giving states time to build their workforce and provider networks. States must first submit implementation plans and prioritize people already stuck on waiting lists.