S 5321 United States Senate · 119th Congress

HCBS Access Act

The HCBS Access Act would require states to cover home and community-based services (HCBS) as a mandatory benefit under Medicaid, effectively eliminating waiting lists for individuals with disabilities and older adults who need support to live in their communities rather than institutions. To fund this expansion, the bill provides a 100% federal matching rate for these services if states meet specific requirements, such as improving workforce wages, removing access barriers, and establishing infrastructure to support self-directed care models. Additionally, the legislation creates a national technical assistance center and authorizes grants to recruit, train, and retain direct care workers, while also prohibiting states from placing liens on the assets of Medicaid recipients for medical assistance correctly paid.
Bill status in committee 1 of 4 stages cleared
Introduction
Aug 2026
Committee Review
Floor Vote
President
Introduced Aug 6, 2026 Last action Aug 6, 2026