Home and Community-Based Services (HCBS) are programs that help people with disabilities, chronic health conditions, and aging-related needs live in their own homes and communities, rather than being placed in nursing homes or other institutions. HCBS programs include both waivers (special programs with extra services for people who need them) and other supports like personal care, day programs, and caregiver help. Medicaid funds HCBS services, enabling 7.8 million people to live independently.
In July 2025, the President signed into law a sweeping bill that will deliver significant cuts and fundamental changes to Medicaid-funded programs, including home and community-based services. We are deeply concerned about the impact that this will have on individuals, families, providers, and the state budget. You can read our full analysis here.
This is a frightening moment. The Arc is here to help you understand this bill and engage in advocacy in Massachusetts. It is important to start by understanding HCBS programs and how they relate to Medicaid. This fact sheet aims to provide a basic overview.
Note: the law that passed in July 2025 will be implemented over the course of the next decade. The law’s provisions have varying implementation dates but taken all together they will radically transform Medicaid and related programs as we know them. The information provided below is a summary as of July 2025. We will make updates as things change.
