Medicaid Waiver Waitlists for Autism: All 50 States (2026)

606,895 people with disabilities are on Medicaid home care waiting lists in the United States, and 552,339 of them have an intellectual or developmental disability. Forty-one states have a waiting list. Ten have none at all. The wait ranges from months to more than two decades, depending entirely on which state you happen to live in.

If you take one thing from this page: get on the list today, even if you're not sure you need it. The list does not care whether you were ready. It only cares what date you applied.

What is a Medicaid waiver, and why does autism qualify?

A Medicaid waiver — formally a Home and Community-Based Services (HCBS) waiver under Section 1915(c) — lets a state use Medicaid dollars to support your child at home and in the community instead of in an institution.

The "waiver" is what gets waived: normally Medicaid counts household income. Under an HCBS waiver, states can waive that and count only the child's income. This is the part most parents miss. A waiver is often the only route to Medicaid for a middle- or higher-income family, because your income stops being the barrier.

Depending on your state, that typically unlocks:

• Respite care — someone else takes care of your child so you can sleep, work, or attend to your other kids

• Therapy beyond what private insurance covers

• Case management

• Home modifications and assistive technology

• Personal care attendants

• Later: supported employment and community integration

A note on ABA, since it comes up right here: we did not choose ABA for our own children. Plenty of families swear by it and would tell you it changed their child's life, and we believe them. Both things are true. A waiver gives you the option and the money — what you do with it is your call, and this site isn't going to push you either way.

The hard part: a waiver is a privilege, not a right

Regular Medicaid is an entitlement. If you qualify, you get it.

A waiver is not. Congress lets states cap how many waiver slots they fund. So states run waiting lists — and in some states, those lists are functionally a wall. This is why "apply now" isn't throwaway advice. In a state with a 15-year interest list, every month you wait is a month permanently added to your wait.

Before you read the table: these numbers are not comparable

This is the single most important thing on this page, and no one explains it to parents.

Some states screen for eligibility before putting you on the list. Some don't. Thirty-five states screen. The rest — including Texas, Florida, South Carolina, Iowa, Oklahoma, and Oregon — let anyone join, whether or not they'd actually qualify.

That means a big list can mean two completely different things:

• South Carolina: 36,824 people waiting, no screening. Some unknown share of those people would never qualify. The list is partly a mailing list.

• Michigan: 27 people waiting, with screening. That is a real, verified queue — and it's tiny.

So a state with a small list is not necessarily better, and a state with a huge list is not necessarily worse. KFF, whose data this is, says it plainly: waiting lists are "an incomplete picture of need." Use the table to find your state's front door, not to compare states.

How long is the Medicaid waiver waitlist in my state?

Source: KFF, Number of People Waiting for Medicaid Home Care (HCBS), 2025 survey — the authoritative national dataset.

*Texas: KFF reports 328,593 on the I/DD interest list but a state total of 181,697 — the state counts people across multiple overlapping interest lists. Either way, Texas has by far the largest waiting population in the country, and some interest lists run 15+ years.

"—" means the state did not report a separate list in that category. It does not mean zero. Always confirm with your state agency.

Reported wait times (where states publish them)

KFF publishes counts, not wait times. These come from state agencies and reporting, and they're the figures that tell you what you're actually in for. Every one below is a reported estimate, not a promise — no agency can predict your individual wait.

Texas families, read this: as of May 2026, HHSC suspended new interest-list slot releases for HCS entirely, citing insufficient appropriations. The list is not moving. Get on it anyway — position is by date, and it will move again.

Which states have no waitlist at all?

Arizona, Delaware, DC, Hawaii, Idaho, Massachusetts, Minnesota, New Hampshire, Rhode Island, and Vermont reported zero people waiting in the 2025 survey.

Separately — and this is the tip most parents never get — roughly a dozen states have adopted Community First Choice (CFC), a Medicaid state plan option. CFC services are an entitlement. There is no waitlist.

So if you're in a CFC state staring down a 15-year interest list, you may still have a route to attendant care and personal support right now, through an entirely different door. Ask your state Medicaid office about Community First Choice by name. Ask even if — especially if — nobody has mentioned it to you.

How do I apply?

The office name changes by state (DDS, DDD, Regional Center, Local Management Entity), but the sequence is the same:

1. Find your state's DD agency. Search "[your state] developmental disabilities waiver waitlist" and click the .gov result, not the clinic ads above it.

2. Ask to be added to the waiting list or interest list. In Texas, that's several separate lists — get on every one you qualify for.

3. Have ready: diagnosis paperwork, Social Security number, proof of residency, and any school or medical evaluations.

4. Get your application date in writing. Email confirmation, letter, screenshot. Your position depends on that date, and lists have lost people.

5. Confirm your position every six months. Set the reminder now. Families get dropped for stale contact information more often than anyone likes to admit.

Can I get moved up the waitlist?

Sometimes — and almost nobody finds this section.

Most states keep urgent-need or crisis categories that move a family up, or off the list entirely. Typical qualifying circumstances:

• The caregiver is aging, seriously ill, or has died

• Immediate risk of institutionalization

• A documented safety risk — elopement, severe self-injury, aggression

• Loss of the current living situation

• Abuse or neglect in the current placement

You have to ask. No one reviews your file proactively and volunteers this. If your circumstances have materially changed, call and say so using your state's own words: "I want to request a crisis-category review."

What do I do while I'm waiting?

This is where most families actually live, and it deserves a straight answer rather than a shrug.

• Apply for SSI separately. Different program, different door — and in most states SSI eligibility brings Medicaid with it automatically. SSI for a child with autism

• Push your school district. Special education is an entitlement with legal deadlines. Unlike the waiver, they have to respond. IEP vs. 504

• Ask about Community First Choice, per above.

• Ask about state-funded family support grants. Many states run small respite or supply grants that almost nobody applies for.

• Get on the list in any state you might move to. If a move is plausible in the next few years, start that clock now.

Sources

• KFF, Number of People Waiting for Medicaid Home Care (HCBS), by Target Population and Whether States Screen for Eligibility, 2025 — kff.org

• KFF, A Look at Waiting Lists for Medicaid Home- and Community-Based Services, 2016–2025

• Medicaid.gov, 1915(c) Home and Community-Based Services waivers

• State DD agency reports

General information, not legal or benefits advice. Waiver rules change constantly and vary enormously by state. Confirm with your state Medicaid or DD agency before making decisions.

We update this page quarterly. Get an email when your state's numbers change