CMS renews four Alaska home- and community-based waivers through 2031

Federal regulators renewed four of Alaska's Medicaid home and community-based care waivers for another five years. The Centers for Medicare and Medicaid Services approved the renewals, effective July 1, 2026, through June 30, 2031.

The Alaska Department of Health's Division of Senior and Disabilities Services announced the approval Tuesday. The renewed programs are the Alaskans Living Independently waiver, the Adults with Physical and Developmental Disabilities waiver, the Children with Complex Medical Conditions waiver, and the waiver for People with Intellectual and Developmental Disabilities.

The waivers cover people who qualify for institutional care but receive support at home instead. Services include care coordination, day habilitation, employment services, residential habilitation, respite, adult host home care and transportation. The Children with Complex Medical Conditions waiver serves children and young adults under 22.

Alaska's fifth waiver, the Individualized Supports Waiver, runs on a separate renewal cycle through June 30, 2028, and was not part of this action.

The division thanked waiver participants, service providers and other stakeholders for their input during the renewal process. "SDS would like to thank waiver participants, waiver services providers, and other stakeholders for their input during the waiver renewal process," the division said. The state took public comment on the proposed renewals before submitting them to CMS, with a deadline of Jan. 30 at 5 p.m.

Current program rules continue to shape access. The waiver for People with Intellectual and Developmental Disabilities selects 50 people from its waitlist each year to apply. The Individualized Supports Waiver, which was not part of this renewal, requires participants to accept a total cost cap on services.

Advocates and stakeholders have noted that renewal alone does not resolve unmet demand or access barriers in home and community-based services, given that Alaska runs five distinct waiver programs on separate timelines.

The Alaska Commission on Aging's 2025 Senior Snapshot put the median annual nursing home cost in Alaska at $364,453 in 2024, the highest in the nation. The commission estimated the state avoided $691 million in costs in fiscal year 2025 by serving people at home instead.

The renewed waivers are posted on the division's HCBS waivers page.