Spectrum Pathways Grades All 50 States and D.C. on Medicaid Waiver Access

MIDVALE, Utah, Oct. 9, 2026 — Spectrum Pathways has published letter grades for the Medicaid home and community-based services (HCBS) waiver systems of all 50 states and the District of Columbia. The free state Medicaid waiver grades are available at spectrumpathways.ai and are intended to help families of people with developmental disabilities compare programs before they apply, appeal or move.

Each state receives a grade from A to F. The published grading methodology lists six weighted factors: HCBS spending per capita, waiting-list length, the number and breadth of waiver programs, the availability of self-determination options, the balance between institutional and community care, and how accessible the application process is. Spectrum Pathways cites federal Centers for Medicare & Medicaid Services (CMS) data, KFF survey data and state agency filings as its sources.

In the current edition, California receives the only A-plus. Arizona and Oregon receive A grades. Alabama and Mississippi receive D grades, the lowest issued. No state receives an F.

Medicaid waivers pay for services that let people with intellectual and developmental disabilities live at home or in the community instead of in an institution. Each state designs its own programs, sets its own eligibility rules and keeps its own waiting list, so the support a family can get depends heavily on where it lives.

Spectrum Pathways grew out of one family's experience. Co-founders Joe and Leona Snyder began building it after their son, Cole, was diagnosed with autism at age 3 and the family worked through Ohio's waiver system, including a denied application and a missed appeal deadline.

Beyond the grades, the site offers a free five-minute Compass Quiz that returns a sequenced action plan, a side-by-side state comparison tool, state-specific appeal templates and deadline reminders. Paid plans start at $99 a year for families, and a professional plan for case managers, attorneys and educators costs $29 per seat per month.

Spectrum Pathways is operated by AI Venture Holdings LLC (AIVH), a Midvale, Utah, venture studio, which built the platform with the Snyder family. The site provides information only and does not give legal, medical or financial advice.