50-State Survey Archives: Medicaid HCBS and Eligibility Based on Disability or Age 65+

Since 2001, KFF’s Program on Medicaid and the Uninsured has administered regular surveys of states about their home- and community-based services (HCBS) programs and their eligibility policies for people who are eligible for Medicaid on the basis of having a disability or being ages 65 and older (e.g., the “non-MAGI” eligibility pathways). Those reports are compiled here.

Use these links to navigate to the surveys and resources on this page.

Medicaid HCBS Surveys
Survey of Medicaid Eligibility Based on Disability or Age 65+ (non-MAGI eligibility)
Related Resources

The Medicaid HCBS survey is sent to officials administering Medicaid HCBS programs in all 50 states and the District of Columbia. The survey is sent to each state official responsible for overseeing the administration of HCBS programs (including home health, personal care, and waiver services). Before 2015, KFF and researchers at University of California San Francisco conducted the survey. Starting in 2016, KFF and Watts Health Policy Consulting have conducted the annual survey. Not all years’ surveys are available because the survey was not administered in some years and in other years, KFF replaced earlier reports with the most recent data.

Surveys are organized by the year in which they were administered, which may not match the date of publication or the year of data reported. Some reports include data from more than one year.

Report links for some prior years are no longer on our website, but may be requested via KFF’s Contact Us form.

2023 Survey

Pandemic-Era Changes to Medicaid Home- and Community-Based Services (HCBS): A Closer Look at Family Caregiver Policies (September 2023)

Payment Rates for Medicaid Home- and Community-Based Services: States’ Responses to Workforce Challenges (October 2023)
A Look at Waiting Lists for Medicaid Home and Community-Based Services (November 2023)

How are States Implementing New Requirements for Medicaid Home- and Community-Based Services? (December 2023)

2022 Survey

Ongoing Impacts of the Pandemic on Medicaid Home & Community-Based Services (HCBS) Programs: Findings from a 50-State Survey (November 2022)

Ending the Public Health Emergency for Medicaid Home- and Community-Based Services (April 2023)

2021 Survey

Medicaid Home & Community-Based Services: People Served and Spending During COVID-19 (March 2022)

State Policy Choices About Medicaid Home and Community-Based Services Amid the Pandemic (March 2022)

2019 Survey

Medicaid Home and Community-Based Services Enrollment and Spending (February 2020)

Key State Policy Choices About Medicaid Home and Community-Based Services (February 2020)

Medicaid’s Money Follows the Person Program: State Progress and Uncertainty Pending Federal Funding Reauthorization (November 2019)

2014 Survey

Medicaid Home and Community-Based Services Programs: 2012 Data Update (November 2015)

2004 Survey

Medicaid 1915(c) Home and Community-Based Service Programs: Data Update (July 2005)

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Medicaid is an important source of health and long-term care coverage for people with disabilities and those who are ages 65 and older. The Medicaid pathways in which eligibility is based on old age or disability are known as “non-MAGI” pathways because they do not use the Modified Adjusted Gross Income (MAGI) financial methodology that applies to pathways for pregnant people, parents, and children with low incomes. In addition to considering old age/disability status and income, many non-MAGI pathways also have asset limits. Since 2015, this survey has been conducted by KFF and Watts Health Policy Consulting. Not all years’ surveys are available because the survey was not administered in some years and in other years, KFF replaced earlier reports with the most recent data.

Surveys are organized by the year in which they were administered, which may not match the date of publication or the year of data reported. Some reports include data from more than one year.

2022 Survey

Medicaid Financial Eligibility in Pathways Based on Old Age or Disability in 2022: Findings from a 50-State Survey (July 2022)

Medicaid Public Health Emergency Unwinding Policies Affecting Seniors & People with Disabilities: Findings from a 50-State Survey (July 2022)

2018 Survey

Medicaid Financial Eligibility for Seniors and People with Disabilities: Findings from a 50-State Survey (June 2019)

Key State Policy Choices About Medical Frailty Determinations for Medicaid Expansion Adults (June 2019)

Implications of the Expiration of Medicaid Long-Term Care Spousal Impoverishment Rules for Community Integration (November 2019)

2015 Survey

Medicaid Financial Eligibility for Seniors and People with Disabilities in 2015 (March 2016)

2009 Survey

Medicaid Financial Eligibility: Primary Pathways for the Elderly and People with Disabilities (February 2010)

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KFF’s ongoing work related to LTSS and people with disabilities provides context and nuance to the data and information presented in the state surveys.

Long-Term Services and Supports

• 10 Things About Long-Term Services and Supports (September 2022)
• Who Uses Medicaid Long-Term Services and Supports (December 2023)
• How Many People Use Medicaid Long-Term Services and Supports and How Much Does Medicaid Spend on Those People? (August 2023)

Nursing Facilities

• A Closer Look at the Final Nursing Facility Rule and Which Facilities Might Meet New Staffing Requirements (May 2024)
• A Look at Nursing Facility Characteristics Between 2015 and 2023 (January 2024)

People with Disabilities

• As Recommendations for Isolation End, How Common is Long COVID? (April 2024)
• Working Age Adults with Disabilities Living in the Community (January 2024)
• Supplemental Security Income for People with Disabilities: Implications for Medicaid (June 2021)

Medicaid Eligibility Rule, 2023-2024

• What Does the Medicaid Eligibility Rule Mean for Low-Income Medicare Beneficiaries and the Medicare Savings Programs (MSPs)? (November 2023)
• Potential Effects of the Proposed Medicaid Eligibility Rule for Newly Enrolled Medicare-Medicaid Enrollees
  (November 2022)
• 5 Things to Know: A Look at the Proposed Medicaid Eligibility & Enrollment Rule (September 2022)