EVERYTHING You Need to Know About Medicaid HCBS

About this Episode

If you’re trying to understand Medicaid HCBS programs and how recent legislation could impact healthcare at home, you’re not alone. Medicaid HCBS programs are confusing. Medicaid HCBS programs are also essential.

In this episode of Who Cares, hosts Elyssa Katz and Dr. Steve Landers dive deep into Medicaid Home and Community-Based Services (HCBS), breaking down their structure, state-level variability, and what looming budget cuts could mean for vulnerable communities.

Dr. Landers kicks off by grounding the conversation in the basics: what Medicaid is, who it serves, and how it supports nearly 80 million Americans, including children, the elderly, pregnant women, and individuals with disabilities. He then provides a rich historical context around HCBS, including the landmark Olmstead decision that changed how the U.S. government is required to provide care for people with intellectual and developmental disabilities.

This episode explains why Medicaid HCBS programs are not just beneficial but they’re vital. Listeners will hear real-world examples of the types of services these programs fund, from home health aides and personal care attendants to adult day care and even Meals on Wheels. The episode also confronts head-on the limitations of Medicaid HCBS: it’s an optional program, not uniformly implemented across states, and often subjected to political and financial pressures.

The conversation transitions into timely policy analysis of the “One Big Beautiful Bill Act” signed into law on July 4th, and its implications for Medicaid HCBS funding. Dr. Landers warns of the cascading effects on state-level budgets, provider taxes, and managed care. He underscores the very real possibility of longer waitlists and reduced access to services, despite these programs ultimately saving money by reducing institutional care needs.

Listeners will also get practical advice. Elyssa and Dr. Landers talk about how providers, constituents, and everyday citizens can advocate for Medicaid HCBS by sharing personal stories, engaging with state representatives, and pushing for strategic policy decisions that recognize home-based care as a cost-saving, dignity-enhancing alternative.

In closing, the hosts make a powerful case for why the U.S. as a wealthy, compassionate nation should double down on investments in Medicaid HCBS. From healthcare policy nerds to everyday caregivers and patients, this episode has something for everyone who believes healthcare should be accessible, humane, and future-ready.