States are not choosing to use their flexibility there. Get in touch with the HCFA people and use them. We found that existing policy can go a long way, but it's up to the state to use it. Income guidelines can even be altered to be a lot better than they usually are. For our world, that's a lot of income.
States can choose that.
All but a handful of people can keep their entire check and still get attendant services. All this work about how things are actually going to happen will still need to be done in your state. Now is the time to figure out what it is you want to happen in your state or your community and get it done. The key is aggregate. Our state uses an aggregate cost cap.