EVIDENCE-BASED HOME VISITING PROGRAMS

States have substantial latitude in how they fund and implement their home visiting programs. Over the last year, several states took legislative action to enhance their support of evidence-based home visiting programs through new funding streams or increased spending on home visiting programs.

1 State Began Covering Evidence-Based Home Visiting Services Under Medicaid

In the last year, Illinois was the only state that began covering evidence-based home visiting services under Medicaid. The state submitted and received approval for a state plan amendment to provide Medicaid coverage for home visiting services, retroactively effective September 2024.

Home visits will provide health, child development, and parenting education; screening; and care coordination to pregnant and parenting individuals with young children. Qualified providers include programs that are fully accredited or meet standards by their national program offices and are one of the state-approved evidence-based models.

2 States Are in the Process of Covering Evidence-Based Home Visiting Services Under Medicaid

Two states are in the process of providing coverage for evidence-based home visiting services under Medicaid. Nebraska enacted legislation to cover evidence-based home visiting programs under the Medicaid targeted case management benefit, which requires the state to submit a Medicaid state plan amendment before implementation. The bill stipulates that the state match for Medicaid reimbursement must be covered with funds returned to the state from managed care organizations that exceed their medical loss ratio. As of September 2025, Nebraska had not yet submitted a state plan amendment for federal review.

Lawmakers in the District of Columbia successfully enacted legislation in 2024 to require the health care programs run by the District—including Medicaid, the DC HealthCare Alliance Program, and the Immigrant Children’s Program—to cover and reimburse services provided by home visiting programs. The legislation requires that services be offered through an evidence-based program as defined by HomVEE. As of September 2025, the District had not yet submitted its state plan amendment for federal review, a step required for implementation.

1 State Enacted Legislation to Require Private Health Plans to Cover Evidence-Based Home Visiting Services

Legislators in Louisiana enacted a bill to require coverage of evidence-based home visiting services, as defined by HomVEE, by any private health insurance plan in the state that provides benefits for maternity services. The bill requires minimum coverage of at least five visits, starting January 2027.

3 States Considered Partnerships Between Medicaid and Evidence-Based Home Visiting Programs

Three states (Iowa, Rhode Island, and Texas) introduced legislation to explore partnerships between their Medicaid and home visiting programs, though none of these proposals passed this session.

• Legislation in Iowa would have given the Department of Health and Human Services approval to seek a waiver to cover home visiting services under Medicaid if it determined doing so would be beneficial.
• The Rhode Island proposal would have added additional requirements to the state’s annual report on home visiting programs, including information on how states have maximized partnerships between Medicaid and home visiting programs.
• Texas’s bill would have required Medicaid coverage of home visiting services and required that managed care organizations in the Medicaid program collaborate with home visiting programs so that if a family loses Medicaid eligibility in the middle of the home visiting program, they can continue to receive home visits.

11 States Continued Investments in Evidence-Based Home Visiting Programs

At least 11 states—Arkansas, Colorado, Delaware, Georgia, Indiana, Louisiana, Minnesota, Nebraska, New Mexico, Oregon, and Washington—continued funding for home visiting programs. Legislators in Georgia expanded their investment to almost $3 million for the state’s pilot program to provide additional home visiting services in at-risk and underserved communities.

Washington legislators appropriated $34.5 million in state funds—maintaining the previous biennium’s allocation—to the Home Visiting Services Account, which pairs public dollars with matching private contributions. Of this funding, about $1.8 million was earmarked to support wage increases and create more equity in contracting among the home visiting provider workforce.

4 States Explored Ways to Improve Access to Home Visiting Services

In Maryland, legislators enacted legislation to establish the Workgroup on Newborn Home Visiting Services, charged with identifying service gaps, potential funding sources, and workforce needs. The group is set to submit a report to the legislature by the end of 2025.

Although ultimately unsuccessful, legislators in California, Maine, and New York introduced bills to better connect families with home visiting programs. California’s legislation would have allowed families who are enrolled in home visiting programs through their participation in CalWORKS, the state’s TANF program, to continue with services even if they lose CalWORKS eligibility. Maine legislators sought to create a study on barriers to a universal referral system to home visiting programs in the state. New York proposed adding home visiting programs to the Health Care and Wellness Education and Outreach Program, which would have allowed for additional and improved outreach to families who may be eligible for services.

Federal Changes to Medicaid May Impact State Medicaid Offerings

In the last year, the federal government passed the 2025 Federal Budget Reconciliation Bill making cuts to federal funding for Medicaid.¹⁶ Work to understand the implications of federal policy changes on state budgets is ongoing, though changes are anticipated to have a detrimental effect on state support for evidence-based policies and strategies such as home visiting.