HCBS Relief Act of 2025

This bill gives states extra federal Medicaid money to support care at home and in the community instead of in nursing homes. For two years, the federal share of these costs goes up by 10 percentage points, with a cap, for approved states during fiscal years 2026 and 2027 . To get the funds, a state must apply and promise to use the money to improve these services and the workforce, not to replace existing state spending, and to spend all the added funds by September 30, 2029 . States must report results by the end of 2029, and the federal government will review how access and quality changed .

The money can help raise pay for home care workers, add paid sick and family leave, offer hazard and overtime pay, stabilize schedules, recruit more workers, and pay for training and travel. It can also help families with caregiver pay and respite, buy protective gear and other supplies, fund assistive technology, provide interpreters and accessible health information, and keep services going during public health emergencies or disasters. It also helps people who had to move into nursing homes return to their own homes by covering moving costs, first month’s rent, and other one-time needs, and by helping them restart services and regain skills . In short, it’s a short-term boost to keep people safely at home with the support they need .

• Who is affected: People on Medicaid who use home and community-based services; home care workers and direct support professionals; family caregivers; and state Medicaid programs .
• What changes: Higher federal match for these services; required use of funds to raise worker pay and benefits, expand services (including for people on waiting lists), support families, buy supplies and technology, and help people move back home from facilities .
• When: Extra federal funding applies to services in FY2026–FY2027; funds must be spent by September 30, 2029; state reports due December 31, 2029 .