No matter how you flip it, Medicaid funding is a never-ending issue. While there are multiple waiver categories to benefit individuals with autism and intellectual and development disabilities (I/DD) via vocational, family, and home and community-based services (HCBS), all equip states to test and tailor their Medicaid programs to their state-specific environments.

But the current administration is revising federal Medicaid Section 1115 waiver policy in ways that can reduce federal funding available to states by discouraging them from pursuing demonstrations (see A New Federal Era for Medicaid Demonstrations: State Waivers to Watch in 2026 and 2027). Along with recent discussions on budget neutrality (see CMS Revises Budget Neutrality Requirements For Medicaid 1115 Demonstrations),…