State Olmstead litigation and the Affordable Care Act.

Over the past two decades, major efforts have been undertaken to expand access to Medicaid home and community-based services (HCBS) for the elderly and disabled. Despite this, many states still have long waiting lists for HCBS. Using data collected, this study examined the trends in Olmstead and related cases against states between 1999 and 2011. The findings show there were 131 cases filed during the period, and 90 cases were resolved through court rulings and settlements. These court cases have played an important role in encouraging states to expand access to HCBS programs and to transfer individuals out of institutions.