1. Short title This Act may be cited as the Community Integration Act of 2018 . 2. Findings Congress finds the following: (1) The Supreme Court’s 1999 decision in Olmstead v. L.C., 527 U.S. 581 (1999), held that the unnecessary segregation of individuals with disabilities is a violation of the Americans with Disabilities Act of 1990 ( 42 U.S.C. 12101 et seq.). (2) Under Olmstead, individuals generally have the right to receive their supports and services in home and community-based settings, rather than in institutional settings, if they so choose. (3) Olmstead envisioned that States would provide appropriate long-term services and supports to individuals with disabilities through home and community-based services and end forced segregation in nursing homes and other institutions. (4) While there has been progress in rebalancing State spending on individuals with disabilities in institutions as compared to home and community-based settings, more than 75 percent of States continue to spend the majority of their long-term care dollars on nursing homes and other institutional settings, and the number of individuals with disabilities under age 65 in nursing homes increased between 2008 and 2012. (5) As of June 2013, there were more than 200,000 individuals younger than age 65 in nursing homes—almost 16 percent of the total nursing home population. (6) Thirty-eight studies published from 2005 to 2012 concluded that providing services in home and community-based settings is less costly than providing care in a nursing home or other institutional setting. (7) No clear or centralized reporting system exists to compare how effectively States are meeting the Olmstead mandate. 3. Ensuring Medicaid beneficiaries may elect to receive care in a home and community-based setting (a) In general Section 1902(a) of the Social Security Act ( 42 U.S.C. 1396a(a) ) is amended— (1) in paragraph (82), by striking and at the end; (2) in paragraph (83), by striking the period and inserting ; and