State Policy · MD
Maryland Cuts Home-Based Services Funding Amid Federal Medicaid Reductions
Maryland enacted cuts to home- and community-based services (HCBS) for Medicaid beneficiaries with disabilities, following federal reductions in Medicaid funding under the One Big Beautiful Bill Act. Advocates partially limited the scope of cuts but could not prevent them. The reductions threaten services that enable people with disabilities to live in community settings rather than institutions. Federal enforcement changes have weakened requirements that states prioritize community-based care over institutional placements, while state budget pressures have accelerated service cuts.
Why it mattersState Medicaid agencies face shrinking federal match rates while managing HCBS programs that federal policy no longer actively enforces, creating fiscal and compliance tensions as states determine which disability services to sustain.