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Capitol Correspondence - 03.08.22

Kaiser Family Foundation Releases Issue Briefs on HCBS

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On Friday, the Kaiser Family Foundation (KFF) released two issue briefs that detail the spending on the Medicaid Home and Community Based Services (HCBS) program in Fiscal Year (FY) 2020 and make the case for the inclusion of increased funding for the HCBS program as part of the budget reconciliation legislation that has been passed by the U.S. House of Representatives.

The first KFF brief, entitled “Medicaid Home & Community-Based Services: People Served and Spending During COVID-19,” reports state-level data on the spending on Medicaid HCBS in FY 2020 and the number of people served. Key findings include that in FY 2020 three million people received HCBS through waivers and that joint federal and state Medicaid HCBS spending totaled $116 billion in FY 2020, with 96% of that total spending used for optional services like HCBS.

The other brief, entitled “State Policy Choices About Medicaid Home and Community-Based Services Amid the Pandemic,” reports data on state policy choices about Medicaid HCBS, including target populations, functional eligibility criteria, financial eligibility criteria, waiver waiting lists, benefit packages, out-of-pocket costs, use of capitated managed care, self-direction opportunities, covered provider types, electronic visit verification systems, and provider reimbursement rates. The brief makes clear that “states’ ability to make longer-term systemic changes and investments to expand access to HCBS is likely to be affected by whether the permanent increase in federal Medicaid matching funds for HCBS” included in the House-passed budget reconciliation bill is enacted into law.