Affordability and Access

Affordability and access means consumers are able to easily find, pay for, and receive the services they need in the setting they choose. Medicaid public safety nets are sufficient to provide peace of mind and security to those who cannot afford services.

There are 6 indicators that measure affordability and access.

Indicators Best State US Average
Medicaid Buy-In State eligibility policies for the Medicaid Buy-In state option for workers with disabilities 100% 48%
Home Care Cost Median annual home care private pay cost as a percentage of median household income ages 65+ 63% 83%
Nursing Home Cost Median annual nursing home private pay cost as a percentage of median household income ages 65+ 153% 213%
Long-Term Care Insurance Private long-term care insurance (LTCI) policies in effect per 1,000 people ages 40+ 132 40
ADRC/NWD Functions Aging and Disability Resource Center/No Wrong Door Functions (composite indicator, scale 0-100%) 97% 72%
Medicaid for Low-Income People with Disabilities Percentage of people with Activity of Daily Living (ADL) disability at or below 250% of poverty receiving Medicaid or other government assistance health insurance, ages 21+ 77% 59%
Indicators No Credit Partial Credit Full Credit
Medicaid HCBS Presumptive Eligibility State policies that allow presumptive eligibility for Medicaid HCBS 40 States 0 States 11 States
On this page

State Performance on Affordability and Access

In a high-performing LTSS system, consumers can easily find and afford services, with meaningfully available safety net for those who cannot afford services. Safety net LTSS do not create disparities by income, race/ethnicity, or geography.

Source: Long-Term Services and Supports State Scorecard, 2023.


See what’s new in this edition…how did your state do?
Explore the LTSS State Scorecard

Stay up to date with LTSS. Receive News and Trends in your Inbox.