Medicaid, state budgets, and the rules that set direct support and I/DD services.
Policy · Policy
Illinois proposed a DD waiver amendment, posted Sept. 10, 2026, that would raise the DSP wage in its rate model to $21.90 statewide from Jan. 1, 2027, with public comments due Oct. 8, 2026.
September 26, 2026 · Illinois Department of Healthcare and Family Services (public notice) · 1 min
Policy · Policy
Governors from 18 states sent a letter, reported Sept. 15, 2026, urging the Justice Department to drop efforts stemming from a June memo that questioned long-standing readings of the Olmstead decision on community services.
September 26, 2026 · Disability Scoop · 1 min
Policy · Policy
Arkansas plans to offer supportive living to the 2,464 people on its CES Waiver waitlist by January 2027 at the latest, at an estimated cost of about $17 million, Gov. Sarah Huckabee Sanders announced Sept. 15, 2026.
September 26, 2026 · Office of Arkansas Gov. Sarah Huckabee Sanders · 1 min
Policy · Policy
CMS guidance released in early September 2026 tells states to check 12 months of claims data first when deciding who is 'medically frail' and exempt from Medicaid work rules that most states must start by early 2027.
September 26, 2026 · Disability Scoop · 1 min
Policy · Explainer
Florida's 2022 budget tied more than $600 million in Medicaid rate money to a $15 wage floor without defining who counted, a question that drove legal fights until 2023 and still applies as the state minimum wage reaches $15 on Sept. 30, 2026.
September 23, 2026 · Florida Agency for Health Care Administration · 6 min
Policy · Ohio
Ohio Senate Bill 35, under consideration in September 2026, would give supported decision-making formal standing as an alternative to guardianship for adults with developmental disabilities.
September 17, 2026 · Disability Scoop · 1 min
Policy · Rates
Louisiana will raise rates for its I/DD home and community services about 3% on Oct. 1, 2026, and lift the DSP wage floor to $9.27, far short of the 14.4% increase its own rate study modeled.
August 27, 2026 · The Center Square · 3 min
Policy · Arizona
Arizona's Parents as Paid Caregivers model never fully put its 2025 cost controls in place, missing up to $493 million in savings, the Arizona Auditor General found in a July 30, 2026 audit.
July 30, 2026 · Arizona Auditor General · 1 min
Policy · The states
At least 18 states have proposed or enacted cuts to home and community-based services or otherwise put aging and disability care at risk since the 2025 federal Medicaid law, a July 2026 Caring Across Generations brief says.
July 15, 2026 · Caring Across Generations · 1 min
Policy · Maryland
On June 30, 2026, Maryland's Developmental Disabilities Administration held provider rates and self-directed wages at June 30 levels until CMS approves its waiver amendment, delaying cuts that had been set to start July 1.
July 2, 2026 · Maryland Matters · 3 min
Policy · Missouri
Missouri Gov. Mike Kehoe signed the state's $50.7 billion fiscal 2027 budget on June 30, 2026, keeping $80.7 million for adults with developmental disabilities that he had proposed cutting.
June 30, 2026 · Missouri Independent · 1 min
Policy · New York
New York's fiscal 2027 budget, signed May 28, 2026, gives OPWDD providers a 2.7% targeted inflationary increase, effective April 1, 2026, with no spending restrictions.
May 29, 2026 · Cerebral Palsy Associations of New York State · 1 min
Policy · Federal
CMS proposed a rule on May 20, 2026, CMS-2449-P, to cap Medicaid state directed payments, with the limit extending to all services, including HCBS, starting in 2029.
May 20, 2026 · Centers for Medicare & Medicaid Services · 1 min
Policy · Federal
Remarks by RFK Jr. and Mehmet Oz questioning Medicaid pay for family caregivers alarmed ANCOR and The Arc, which said in April 2026 that the comments undervalue essential care.
April 23, 2026 · Disability Scoop · 1 min
Policy · Federal
CMS delayed enforcement of the Access Rule's grievance system for fee-for-service Medicaid HCBS, due in July 2026, until Dec. 31, 2027, Disability Scoop reported April 17, 2026.
April 17, 2026 · Disability Scoop · 1 min
Policy · Colorado
Colorado will cut long-term services and supports rates 2% starting July 1, 2026, phase in a weekly cap on caregiver hours and slow new DD waiver enrollments, the state said April 8, 2026.
April 8, 2026 · Colorado Department of Health Care Policy and Financing · 1 min
Policy · Idaho
Idaho Gov. Brad Little signed House Bill 863 in March 2026, cutting residential habilitation rates by $21.8 million next fiscal year, about a 10% cut when combined with last year's reductions.
March 27, 2026 · KMVT · 1 min
Policy · Iowa
Iowans with disabilities are facing cuts to Medicaid waiver home care hours, including a managed care plan's bid to cut one man's support by nearly 40%, KFF Health News reported in March 2026.
March 5, 2026 · KFF Health News · 1 min
Policy · Federal
CMS announced Feb. 25, 2026, that it was deferring $259.5 million in quarterly federal Medicaid funding to Minnesota over questionable personal care and HCBS claims, and warned it could defer over $1 billion.
February 25, 2026 · Centers for Medicare & Medicaid Services · 1 min
Policy · Federal
The federal Lifespan Respite Care Program was renewed for five years in a spending package signed in February 2026, with $11 million this year for state respite systems, up from $10 million.
February 24, 2026 · Disability Scoop · 1 min
Policy · North Carolina
North Carolina restored Medicaid provider rates to their Sept. 30, 2025 levels in December 2025 after court rulings, but the state warned a $319 million shortfall remained unsolved.
December 10, 2025 · North Carolina Department of Health and Human Services · 1 min
Policy · The data
KFF's survey of states, published Nov. 20, 2025, counted about 607,000 people on waiting lists for Medicaid home care in 41 states in 2025, up 14% from 2024, with people with I/DD making up 74% of them.
November 20, 2025 · KFF · 2 min
Policy · Federal
CMS told states on Nov. 14, 2025, that under the 2025 reconciliation law it will generally bar new or increased Medicaid provider taxes from Oct. 1, 2026, and gave states with non-compliant taxes until fiscal 2026 or 2028 to comply.
November 14, 2025 · Centers for Medicare & Medicaid Services · 2 min
Policy · Colorado
Colorado paused its plan to pay family caregivers of adults with developmental disabilities the lower host-home rate on Feb. 3, 2026, after the Joint Budget Committee tabled the change, which the state had projected would save $1.45 million in general funds.
November 6, 2025 · The Colorado Sun · 2 min
Policy · California
A 10% cut to five Medi-Cal home and community-based services programs would raise California's long-term care costs by $57 million in year one and $1.17 billion over 2026-2030, an ATI Advisory brief for CHCF published Oct. 23, 2025, found.
October 23, 2025 · California Health Care Foundation · 2 min
Policy · Arizona
Arizona paused its new HCBS Needs Tool for children on Oct. 16, 2025, restoring the care hours families had before Oct. 1 and adding an Extraordinary Care Review exception process through an emergency rule.
October 16, 2025 · KJZZ · 2 min
Policy · Policy
On Sept. 25, 2025, NC Medicaid announced rate cuts effective Oct. 1, 2025, including 8% for ICF-IID and personal care services and payment of Innovations, 1915(i) and TBI waiver services at 97% of prior rates.
September 25, 2025 · NC Medicaid · 1 min
Policy · Policy
On Aug. 22, 2025, the Idaho Department of Health and Welfare told Medicaid providers it would cut reimbursement rates 4% for nearly all provider types effective Sept. 1, 2025, after Medicaid cost growth ran near 19%.
August 22, 2025 · Idaho Reports · 1 min
Policy · Policy
On July 3, 2025, Congress passed H.R. 1, which Disability Scoop reported cuts Medicaid by almost $1 trillion and which adds work requirements, six-month eligibility checks for expansion adults and a new HCBS waiver option starting in 2028.
July 3, 2025 · H.R. 1 enrolled text (GovInfo) · 1 min
Policy · Policy
On April 24, 2025, Arizona Gov. Katie Hobbs signed HB 2945, a roughly $122 million emergency package that kept the Division of Developmental Disabilities from running out of money and set new limits on paid parent caregivers.
April 24, 2025 · Arizona Legislature, HB 2945 summary · 1 min
Policy · Policy
On Feb. 25, 2025, the House adopted a budget resolution 217-215 that instructed the Energy and Commerce Committee, which oversees Medicaid, to cut at least $880 billion over 10 years.
February 25, 2025 · Congress.gov (H.Con.Res. 14) · 1 min
Policy · Policy
On Sept. 26, 2024, Texas and 16 other states sued HHS in federal court in Lubbock to block parts of its May 2024 Section 504 disability rule, including its gender dysphoria language and most integrated setting provisions.
September 26, 2024 · Texas v. Becerra complaint (N.D. Tex.) · 1 min
Policy · Policy
In June 2024, Minnesotans with disabilities voiced fears that the state's Waiver Reimagine plan, which would fold four disability waivers used by about 70,000 people into two, could push more people into group homes.
June 1, 2024 · Minnesota Star Tribune · 1 min
Policy · Policy
On April 22, 2024, CMS finalized its Medicaid access rule, requiring that in six years at least 80% of payments for homemaker, home health aide and personal care services go to direct care worker compensation.
April 22, 2024 · CMS fact sheet (CMS-2442-F) · 1 min
Policy · Policy
On March 6, 2024, ANCOR and United Cerebral Palsy's Case for Inclusion report counted 497,354 people on state HCBS waiting lists and full-time DSP vacancy rates of 16.5%.
March 6, 2024 · ANCOR · 1 min
Policy · Policy
On Feb. 6, 2024, Pennsylvania Gov. Josh Shapiro proposed $215 million in state funds, drawing $266 million in federal money, to raise rates for intellectual disability and autism service providers.
February 6, 2024 · Office of Gov. Josh Shapiro · 1 min
Policy · Policy
On Sept. 7, 2023, HHS proposed its first major update to its Section 504 disability rule in decades, adding requirements on medical treatment, accessible equipment, web accessibility and the most integrated setting, with comments due Nov. 13.
September 7, 2023 · Federal Register (88 FR 63392) · 1 min
Policy · Policy
On May 3, 2023, CMS proposed a Medicaid access rule that would require at least 80% of payments for personal care, homemaker and home health aide services to go to worker compensation, plus new rate, waitlist and grievance requirements.
May 3, 2023 · Federal Register (88 FR 27960) · 1 min
Policy · Policy
On April 18, 2023, President Biden signed Executive Order 14095, which directed federal health officials to consider new Medicaid rules on home and community-based services and asked the Labor Department to study home care pay.
April 18, 2023 · Federal Register (88 FR 24669) · 1 min
Policy · Policy
In late January 2023, the Biden administration said it would end the COVID-19 public health emergency on May 11, 2023, while Medicaid continuous enrollment was set to end March 31 and HCBS Appendix K flexibilities six months after the emergency.
February 6, 2023 · Office of Management and Budget · 1 min
Policy · Policy
On Jan. 26, 2023, Sen. Bob Casey and Rep. Debbie Dingell reintroduced the Better Care Better Jobs Act, which would permanently raise the federal Medicaid match for home and community-based services by 10 percentage points in states that meet new standards.
January 26, 2023 · U.S. Senate Special Committee on Aging · 1 min