HCBS Access Act

S. 5321 would amend Medicaid (Title XIX of the Social Security Act) to require states to cover home and community-based services (HCBS) — supports that let people receive long-term care in their own homes or communities rather than in institutions — and to expand access to those services. It would also create grant programs to help build the direct care workforce, covering recruitment, training, education, retention, and career advancement for workers who provide this care, and separate grants to support family caregivers.

The bill would primarily affect Medicaid enrollees who need long-term care, particularly older adults and people with disabilities who rely on or seek home- and community-based alternatives to institutional care. It would also affect direct care workers, through workforce-development funding, and family members who provide unpaid caregiving, through the caregiver support grants. Medicaid programs, which are jointly administered by states and the federal government, would be affected by the new coverage requirement.

The bill was introduced in the Senate on August 6, 2026, by Sen. Ben Ray Luján (D-NM), and its only recorded action so far is introduction. It would next need to be reviewed by committee before any further action, such as a committee vote or floor consideration, could occur. The full legislative text has not yet been published, so specific provisions, funding levels, and implementation details are not yet publicly available.

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