What is Medicaid Home Care (HCBS)?

(By Maiss Mohamed, Alice Burns, and Molly O’Malley Watts for The Kaiser Family Foundation Published: Feb 18, 2025)

Many older adults and people with disabilities require assistance with self-care such as bathing, dressing, and eating. Help with such services is known as “long-term care” and may be provided in institutional settings such as nursing facilities or in people’s homes and the community, including assisted living facilities. Four in ten adults incorrectly believe that Medicare is the primary source of coverage for low-income people who need nursing or home care, but Medicaid is the primary payer—covering two-thirds of all home care spending in the United States in 2022. With House Republicans considering $2.3 trillion in Medicaid cuts over 10 years—a nearly one-third reduction in Medicaid spending—the availability of home care could be affected in future years. This issue brief provides an overview of what Medicaid home care (also known as “home- and community-based services” or HCBS) is, who is covered, and what services were available in 2024. About 4.5 million people receive Medicaid covered home care services annually. Continue reading here…

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