American Rescue Plan Act (ARPA)

This brief shares 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 from the KKF shares state-level data on HCBS spending and the number of people receiving Medicaid in FY 2020. The data were collected in KFF’s 19th survey of state officials administering Medicaid HCBS programs in all 50 states and DC.

This NRP article discusses the delay many states are experiencing in regard to accessing funding from the American Rescue Plan Act, signed into law in March 2021. The increased funding could be used by states to boost wages, move people off waiting lists for disability services, train more workers, and expand covered services for older adults and people with disabilities, however the Centers for Medicare and Medicaid Services must provide approval before states can fully access their funds.

The Wisconsin Department of Health Services proposes to reinvest ARPA Home and Community Based Services (HCBS) enhanced funding to implement a statewide grant program with HCBS providers, advocates and stakeholders. These grants will address the workforce crisis, support businesses and programs transition to a model that supports individual with intellectual, developmental, and other significant disabilities find and retain work in competitive integrated employment and other innovative solutions.

COVID-19 is a long-lasting and complex disaster situation involving a public health emergency and an economic crisis, with particularly acute impacts for older adults, people with disabilities, and others with certain health conditions. States are responding with changes in policies and procedures to ensure individuals have access to public benefit programs (e.g. Medicare Savings Programs, LIS/Extra Help, SNAP, and LIHEAP). ADvancing States has a new brief highlighting where states are with benefit access and enrollment since the onset of the COVID-19 pandemic. Results in the brief comes from the 2021 ADvancing States Membership Survey: COVID-19 Benefits Access and Enrollment, a follow-up to the 2020 survey.

The American Rescue Plan Act (ARPA) included a 10% FMAP increase to Medicaid-funded HCBS. CMS requires states to submit semi-annual spending plan updates outlining changes to previously approved activities using ARPA HCBS funding. ADvancing States released an analysis of states’ initial spending plan submissions in September 2021, grouping activities into tables focusing on ten areas.

This issue brief presents early findings from the most recent KFF 50-state survey of Medicaid HCBS programs, focusing on state policies adopted in response to the pandemic, the pandemic’s impact on Medicaid HCBS enrollees and providers, and states’ early plans for the new American Rescue Plan Act (ARPA) 10 percentage point temporary increase in federal Medicaid matching funds for HCBS.