Home and Community Based Services Impacts Tracker Project | Health Policy and Management Matters

States’ Medicaid programs are facing increased budget pressure from federal policy changes, including over $900 billion in reduced federal Medicaid funding due to the 2025 reconciliation bill, H.R. 1 (OBBBA). Based on evidence from past major reductions of federal Medicaid funds, many states are likely to respond by cutting optional services like Home and Community-Based Services (HCBS), services that support older adults and people with disabilities to live in their homes and communities. Some states are already proposing and implementing HCBS cuts.

The HCBS Impacts Tracker Project aims to track policy changes states propose or implement in their HCBS programs and to measure the impacts of those changes on older adults and people with disabilities. During this initial phase, the project will develop the methodology for tracking and pilot a tracking tool. This planning grant will inform the next phase of this project: establishing a sustainable, national resource with real-time information for use by policymakers, advocates, researchers, and people with lived experience to track Medicaid HCBS policy shifts and their impacts at a state and national level.

The HCBS Impacts Tracker Project is led by the George Washington University Milken Institute School of Public Health Hirsh Health Law and Policy Program together with Human Services Research Institute, LeadingAge LTSS Center @UMass Boston, and ATI Advisory. This project is funded by The SCAN Foundation with collaborating support from the WITH Foundation.

HCBS Impacts Tracker

The HCBS Impact Tracker includes proposed and implemented changes by states to their HCBS programs. It is a work in progress and in a pilot phase. In an effort to fill a need we are hearing from national and state partners, we are making this information available. We encourage you to bookmark the tracker to stay up to date with the biweekly updates. If we are missing any state policy changes or information is incorrect, please complete the HCBS Information Collection Form linked below to let us know.

The tracker was last updated May 8, 2026.

HCBS Information Collection Form

Please use the HCBS Information Collection Form to let us know about a proposed or implemented change that we are missing from the HCBS Impacts Tracker. This form is intended to be completed by national, state, or local organizations.

This tracker is owned by GW Milken Institute School of Public Health, Human Services Research Institute, LeadingAge LTSS Center @UMass Boston, and ATI Advisory. If you have any questions or comments, you can contact us at HCBSTrackergwu [dot] edu (HCBSTracker[at]gwu[dot]edu).