Congress is considering legislation to expand the availability of Medicaid home and community-based services (HCBS) by making additional resources available to states as part of a larger reconciliation bill. Although the reconciliation bill does not have bipartisan support, Democrats and Republicans have historically supported efforts to expand HCBS. This report focuses on streamlining and simplifying states’ HCBS waiver and state plan authorities into a single state plan amendment (SPA), with the goal of reducing complexity for states administering the programs and for beneficiaries navigating the system. Streamlining and simplifying the program would make services more uniform from state to state and across populations within a state. 

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