Diamonds of Disability has published a 50-state ranking of disability support infrastructure, arriving as the Congressional Budget Office estimates federal Medicaid cuts of approximately 911 billion dollars through 2034, with home and community-based services considered the most exposed to reductions.
— Diamonds of Disability has published a report analyzing disability support infrastructure across all 50 U.S. states. The report evaluates eight categories affecting daily life for disabled adults, including Medicaid waiver access, home and community-based services waitlists, in-home caregiver support, housing affordability, transportation and vocational rehabilitation outcomes. The ranking is intended to help disabled adults and families evaluate relocation decisions based on access to reliable support systems.
The complete ranking is available at https://diamondsofdisability.com/articles/all-50-states-ranked-for-disability-support-the-complete-reference-guide
The report coincides with a significant decrease in federal Medicaid funding: it is estimated that the federal budget reconciliation law enacted in July 2025 will reduce federal Medicaid spending by approximately 911 billion dollars through 2034, according to an analysis published by KFF, an independent health policy research organization. States typically reduce optional benefits such as home and community-based services first when federal Medicaid funding tightens, which disability advocates say poses a particular risk to in-home care programs many disabled adults rely on to remain in their communities rather than institutional settings. At least nine states had already proposed reducing or eliminating home and community-based services funding as of March 2026, according to the report, underscoring why state-level differences in absorbing that pressure have become more consequential for people weighing where to live.
The new ranking draws on five sources for its methodology. The AARP Long-Term Services and Supports Scorecard 2023, which evaluates all 51 U.S. jurisdictions across 50 indicators, serves as its foundation. Diamonds of Disability supplemented that scorecard with 2025 Medicaid waiver waitlist data from KFF, WorldPopulationReview’s disability index, Policygenius’s disability livability ranking, and the AAA State of Play accessibility index, combining healthcare access, housing costs, employment outcomes and state tax policy into a single comparative framework.
The report provides separate guidance depending on a reader’s priority, since the organization found no single ranking serves every disability experience equally. It identifies states with entitlement-model programs that eliminate waitlist caps for readers prioritizing in-home personal care, and separately profiles states where Supplemental Security Income can cover basic housing costs for those prioritizing affordability, noting the two priorities frequently trade off. The report also emphasizes that Medicaid waiver services do not transfer between states, meaning a move to a higher-ranked state provides access to that state’s application process and waitlist rather than immediate enrollment.
Disabled adults and families researching relocation decisions can access the full range of resources from Diamonds of Disability at https://diamondsofdisability.com
Contact Info:
Name: Thomas Gurnee
Email: Send Email
Organization: Diamonds of Disability
Address: 260 South 1200 West, Orem, Utah 84058, United States
Website: https://diamondsofdisability.com
Release ID: 89202186
