Preserving HCBS Amid Budget Uncertainty

Medicaid covers over 9.1 million Americans who need long-term services and supports (LTSS). Expenditures on LTSS, including HCBS, make up over half of Medicaid's budget. The One Big Beautiful Bill Act (OBBBA) requires cuts to Medicaid over the next decade, putting HCBS funding at risk. Since HCBS are optional under federal law, states facing budget constraints can limit access or reduce services. Researchers estimate that OBBBA could force millions aged 50 and older into institutional care and increase costs, reversing progress made toward community-based services.

Despite these challenges, opportunities remain to preserve HCBS, potentially helping states save money and reduce costs for families. Aurrera Health Group developed the "Preserving HCBS Access Amid Budget Uncertainty" toolkit to highlight options available to policymakers to balance access and budget constraints.

For states that want to explore strategies to safeguard their HCBS programs, Aurrera Health Group is available to support policy development, stakeholder engagement, program design and implementation tailored to your needs. Please reach out to Kristal Vardaman to learn more.

To download the toolkit, please provide your contact information below and look for a link to appear on this page.

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Author

Brendan Finn [Senior Policy Consultant]

Kristal Vardaman [Managing Principal]