OBBBA Standalone HCBS Waiver (Non-Institutional LOC, 2028)¶
Future Medicaid waiver authority created by the One Big Beautiful Bill Act (P.L. 119-21, signed July 4, 2025) that will allow states to offer HCBS waivers — including respite and caregiver supports — to people who do NOT yet meet institutional level of care. Available starting July 1, 2028. CMS guidance issued November 2025; $50M FY2026 and $100M FY2027 in state infrastructure funding already appropriated. No state has adopted yet. Tracking stub: state-level adoptions should be recorded when states submit waiver amendments.
From July 1, 2028, states may offer HCBS waivers under a new §1915(c)-style authority for people who do not yet require institutional level of care. Anticipated services: respite care, adult day health, personal care, caregiver training and support, and self-directed services where family members can be paid caregivers. $50M in FY2026 and $100M in FY2027 infrastructure funding has been appropriated to help states build waiver applications. CMS issued preliminary guidance (CIB 11-18-2025) November 2025. No state has adopted as of June 2026. This record is a tracking stub — check back after July 2028 for state adoption status and eligibility details.
Some details for this program are still being verified. Check the official source for the most current information.
Services¶
From July 1, 2028, states may offer HCBS waivers under a new §1915(c)-style authority for people who do not yet require institutional level of care. Anticipated services: respite care, adult day health, personal care, caregiver training and support, and self-directed services where family members can be paid caregivers. $50M in FY2026 and $100M in FY2027 infrastructure funding has been appropriated to help states build waiver applications. CMS issued preliminary guidance (CIB 11-18-2025) November 2025. No state has adopted as of June 2026. This record is a tracking stub — check back after July 2028 for state adoption status and eligibility details.
How to apply¶
Apply online or find more information at the official program page.