119th (2025–2027)
H.R. 8540
The HCBS Access Act would require state Medicaid programs to cover home and community-based services for older adults and people with disabilities, aiming to eliminate waiting lists and reduce unnecessary institutionalization while addressing disparities in access. The bill establishes a comprehensive federal definition of covered services—including personal care, supported employment, housing support, and behavioral health services—and mandates individualized assessments within 30 days, annual reassessments, and person-centered care plans for all eligible individuals. Beginning five years after enactment, HCBS would become a mandatory Medicaid benefit with 100 percent federal funding, and the bill eliminates Medicaid estate recovery and liens on beneficiaries' property. The legislation also supports the direct care workforce through a national technical assistance center, workforce development grants focused on recruitment and retention, and a separate occupational classification code for direct support professionals. Additionally, the bill makes the "Money Follows the Person" program permanent to fund transitions from institutions to community settings, establishes quality metrics to track access and satisfaction, and requires a comprehensive national survey by 2038 to evaluate the law's effects on services, workforce conditions, and economic outcomes.