States’ Deployment of Short-Term Funding in Home- and Community-Based Services Exposes Need for Longer-Term Investments

Medicaid home and community-based services (HCBS) is a critical system for serving low-income seniors and allowing them to age at home rather than in congregate care facilities like nursing homes. Despite the vital role that Medicaid HCBS plays in ensuring that some of the most vulnerable populations are able to receive quality care in their preferred setting, HCBS has been historically underfunded with long wait times. In 2021, states received a rare opportunity to boost resources for these critical services for elderly and disabled populations when President Biden signed the American Rescue Plan Act (ARPA) of 2021 into law. ARPA included a wideranging set of policies and funding, including $12.7 billion made available to state Medicaid programs, according to Congressional Budget Office. This funding was intended to address the ongoing COVID-19 pandemic and the disruption to the economy.