Americans Need Home and Community-Based Services

On Capitol Hill, legislators are examining the federal government’s resources and support for caregivers. The HCBS Access Act would make HCBS a mandated benefit under Medicaid, allowing eligible seniors and those with disabilities to choose between home care and institutional care.

The HCBS Access Act will also improve the caregiving workforce by providing respite for family caregivers, creating jobs and revenue, and increasing wages for home care providers. More than 53 million people nationwide are unpaid family caregivers, according to AARP.

Presently, institutional care is funded by Medicaid for anybody who qualifies. Still, people with disabilities typically have to wait years on waiver waiting lists to access support in the community. In some states, the wait is more than a decade.

The HCBS Access Act was introduced in 2021. The House also passed legislation that year to invest $150 billion in the nation’s home and community-based services system in order to eliminate waiting lists and improve the direct support professional workforce. However, the bill was never brought to a vote in the Senate. President Joseph Biden recently reaffirmed efforts for Congress to approve $150 billion in financing over ten years as part of his fiscal plan this month.

Millions of disabled people nationwide rely on Medicaid to live in their communities. Medicaid waivers can provide a range of services. Examples of covered services under a Medicaid waiver include physical, occupational, and speech therapies, durable medical equipment, home healthcare, home-delivered meals, and dietary management.

I am one of the millions of Americans who benefit from home and community-based services. I have Cerebral Palsy and rely on Massachusetts Medicaid to pay for my PCA services. Unfortunately, the annual cost is more than $50,000. I couldn’t afford to pay for my care out of pocket.

Medicaid allows me to live in an apartment in my community. Home and community-based services are not covered by private insurance. I live in an apartment with my best friend. There’s no place I’d rather be. I live in the same town I grew up in.

Medicaid’s home and community-based services enable disabled people to live at home rather than in an institution. Medicaid is vital for many individuals, including me. Waiting lists need to be eliminated, and Medicaid must be expanded. Without help, people are often forced into unsafe environments, which can have devastating consequences.


Diament, Michelle. “Congress Could Make Waiting Lists for Disability Services a Thing of the Past.” Disability Scoop, Disability Scoop, 20 Mar. 2023,

“Dingell, Casey, Bowman, Introduce Legislation to Make Home Care Coverage Mandatory under Medicaid.” U.S. Representative Debbie Dingell, United States House of Representatives, 9 Mar. 2023,

Garriss, Kirstin. “Congress Examines Support for Caregivers as Millions Rely on Home &Community-Based Care.” WFTV, Cox Media Group, 14 Mar. 2023,

Griffin, Nicole. “Thousands of Disabled Floridians Spending Years on Medicaid Waiver Waitlist.” Spectrum News 13, Spectrum News, 31 Oct. 2022,

“Home- and Community-Based Services.” Centers for Medicare & Medicaid Services, United States Department of Health and Human Services,

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