Medicaid costs force states to limit growth of home, community-based services

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Fiscal difficulties are limiting states' willingness to expand home-and community-based care options, a new report from the Kaiser Commission on Medicaid and the Uninsured (KCMU) has found.

As they attempt to rein in Medicaid spending, states are using waiting lists to delay service implementation, authors suggest. Optional 1915(c) HCBS waivers are one of three main home and community-based services programs states can operate.

In 2004, a total of 206,427 people were on waiting lists for 102 waivers in 34 states. Waivers for the elderly/disabled had the greatest number of people on waiting lists in 2004.

The report is available at