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The HCBS Access Act—Realizing the Promise of Olmstead

Today, we commemorate the 24th anniversary of the Supreme Court’s Olmstead v. L.C. decision recognizing the right of plaintiffs Lois Curtis and Elaine Wilson and people with disabilities of all ages to live, work, and participate in their communities. Unfortunately, this right is not yet realized for millions of older adults and people with disabilities because the Medicaid home and community-based services (HCBS) system does not have the capacity to meet the current and growing need.

Due to persistent underfunding and bias in federal Medicaid law that funnels more money into institutional care than in-home care, significant gaps, inconsistencies, and inequities exist in HCBS across states. This leads to older adults and people with disabilities living in nursing facilities and other institutions when they do not need to be. On this anniversary of the Olmstead decision, we reaffirm our commitment to rectifying this disparity to ensure that all older adults and people with disabilities have the option to live in their preferred environment.

The HCBS Access Act (HAA) is new federal legislation that would help realize the Olmstead decision by creating the HCBS system we need to enable all people with Medicaid, regardless of age, race, disability, or location, to live at home and remain connected to their communities. By expanding access to HCBS, ending the institutional bias, identifying and addressing disparities, and bolstering the HCBS workforce, the HAA aims to create a more inclusive and accessible HCBS system for all.

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