Medicaid Is Changing Again: 4 Things Every Virginia Disability Family Should Do Before December
If you’ve been feeling a low hum of anxiety every time you see the word “Medicaid” in a headline lately, you’re not imagining things.
Something big is happening.
And for families who depend on home and community-based services in Virginia – families like the ones we serve every day at Community Direct Services – the next several months matter more than usual.
We’re not here to scare you.
We’re here to make sure you’re prepared.
What’s Actually Happening
Last summer, Congress passed sweeping legislation that includes nearly $1 trillion in reductions to federal Medicaid spending over the next decade.
The law, often referred to as the One Big Beautiful Bill Act – doesn’t specifically target disability services.
But disability advocates across the country have been sounding the alarm because the downstream effects are real and unavoidable.
Here’s why.
Medicaid is the primary funding source for home and community-based services (HCBS).
The waiver programs that pay for things like personal care, respite, supported employment, companion care, and residential support.
In Virginia, these services are delivered through the DD Waivers (Building Independence, Family and Individual Support, and Community Living) and the CCC Plus Waiver.
The problem is that HCBS is technically optional under federal Medicaid rules.
When federal funding shrinks, states have to make hard budget choices, and optional services are historically the first on the chopping block.
The Autistic Self Advocacy Network has warned that reduced HCBS funding could result in individuals losing access to essential daily support – assistance with eating, dressing, using the bathroom, getting to work.
This isn’t theoretical.
It’s already starting to play out at the state level. Lawmakers in multiple states are weighing proposals to reduce funding for community-based disability services, citing financial pressure from the federal cuts.
What This Means for Virginia Families Specifically
Virginia has been a relatively strong state for disability services.
The DD Waiver expansion we wrote about in our Golden Ticket post earlier this year is still moving forward, and the state has shown commitment to community-based care.
But Virginia isn’t immune to what’s coming.
Several provisions are taking shape right now.
Among the most significant: beginning with renewals scheduled on or after December 31, 2026…
States will be required to conduct Medicaid eligibility redeterminations every six months for adults covered through ACA Medicaid expansion, up from the current annual cycle.
Most families will start experiencing this change in early 2027.
That means more paperwork, more deadlines, and more opportunities for eligible families to accidentally fall through the cracks.
Now, if your loved one receives services through a Virginia DD Waiver (not ACA expansion), the six-month redetermination doesn’t apply directly to them.
But here’s why it still matters: the broader Medicaid funding cuts that come with this law – nearly $1 trillion over the next decade – put pressure on every part of the system, including the home and community-based services that DD Waiver families depend on.
When states face budget shortfalls, optional services like HCBS are historically the first to be reduced.
The good news for disability families: the federal law does provide exemptions from new work requirements for individuals who are medically frail or have physical, intellectual, or developmental disabilities.
Parents, guardians, and family caregivers of those with disabilities are also exempt.
But, and this is important – exemptions only protect you if the paperwork proves you qualify.
The bureaucracy doesn’t give you the benefit of the doubt.
4 Things You Should Do Before December 2026
We’ve been in this work for almost 20 years. We’ve watched Medicaid policies shift before.
And the families who come through these changes in the best shape are always the ones who prepared early.
Here’s what we’re recommending to every family we work with right now.
1. Update Every Piece of Documentation You Have
This is the single most important thing you can do.
When Virginia begins its more frequent eligibility reviews later this year, your loved one’s file needs to clearly show that they qualify for services.
That means current medical records, current functional assessments, and current contact information with your local Community Services Board.
If your loved one had a SIS-A assessment more than two years ago, talk to your support coordinator about whether a reassessment would strengthen your case.
If your physician records don’t reflect the current level of support your loved one requires, schedule an appointment to update them.
Don’t assume what’s on file is still accurate. Check.
2. Understand Exactly Which Waiver Services Your Family Uses
Many families we talk to aren’t sure which waiver they’re on, what services are authorized, or how many hours are allocated.
That uncertainty becomes a problem when the state asks you to verify your eligibility on a tighter timeline.
Pull out your most recent Individual Support Plan (ISP). Review it with your support coordinator.
Make sure you understand what’s currently authorized, what you’re actually using, and whether there are services you’re entitled to but haven’t activated.
If you’re on Virginia’s DD Waiver waitlist and haven’t received a slot yet, make sure your contact information is current with DBHDS.
Missed mail or an outdated phone number could mean a missed slot notification.
3. Build Your Advocacy File
If there’s one lesson from our experience with 200+ Hampton Roads families, it’s this…
Families who document everything are families who keep their services.
Start a folder – physical or digital, and keep copies of the following:
- All correspondence from DMAS, your CSB, and your waiver provider
- Medical records and specialist evaluations
- Your loved one’s current ISP
- Any denial letters or service change notices (and your responses)
- Notes from phone calls, including the date, who you spoke with, and what was discussed
If something changes with your services, you want a paper trail.
Not because you expect a fight, but because documentation is your strongest tool if one ever comes.
4. Connect With Your Provider and Ask Questions Now
This is where a good provider relationship makes all the difference.
If you’re working with a care provider – whether that’s CDS or someone else – reach out and ask them directly:
“How are you preparing for the Medicaid changes coming this year, and what do I need to do?”
A provider who can’t answer that question clearly should concern you.
At Community Direct Services, we’re actively monitoring every policy update coming out of Richmond and Washington.
We’re working with our support coordinators to identify any families whose documentation may need updating.
And we’re making sure every family we serve understands what’s changing, when, and what steps to take.
That’s what being a partner in care actually looks like.
Not just delivering services, but watching the road ahead on your behalf.
What We Don’t Want You to Do
Panic.
The headlines are alarming. The numbers are large.
And the uncertainty is real.
But the disability community has faced funding threats before, and Virginia families have consistently shown up – for their loved ones and for each other.
The advocacy organizations fighting on your behalf are formidable.
The Arc of the United States is actively pushing back on implementation details.
The National Disability Navigator Resource Collaborative is tracking state-by-state impacts.
And the disAbility Law Center of Virginia remains a resource for families who need legal guidance.
You don’t have to navigate this alone.
And you shouldn’t.
We’re Watching This – So You Can Focus on Your Family
We’ll continue to update our blog as policy details become clearer throughout 2026. If you have specific questions about how these changes might affect your family’s services, we’re always available.
Call us: 757-965-4899
Email: info@cdsva.com
Visit: communitydirectservices.com/contact
Your loved one’s care is worth protecting.
Let’s make sure it’s protected.
Sources & Resources
- Disability Scoop — Congress Approves Nearly $1 Trillion in Medicaid Cuts: disabilityscoop.com
- Disability Scoop — Nation’s Disability Services Face Unprecedented Threats (March 2026): disabilityscoop.com
- Disability Scoop — Medicaid Changes Could Limit Access for People with Disabilities: disabilityscoop.com
- Clearbrook — Impact of OBBBA on Individuals with Disabilities: clearbrook.org
- APA Services — Update on Cuts to Medicaid Funding: updates.apaservices.org
- Virginia DBHDS — Waiver Services: dbhds.virginia.gov/developmental-services/waiver-services
- Virginia DMAS — Waivers: dmas.virginia.gov/for-members/benefits-and-services/waivers
- The Arc of the United States: thearc.org
- disAbility Law Center of Virginia: dlcv.org
- National Disability Navigator Resource Collaborative: nationaldisabilitynavigator.org
- CDS Blog — Your Golden Ticket (DD Waiver Guide): communitydirectservices.com
- CDS Blog — Federal Medicaid Cuts Guide: communitydirectservices.com
