California Seniors and Disabled Face Threats to In-Home Care Amid Potential Medicaid Cuts

For over half a century, low-income seniors and disabled residents in California have relied on government-funded in-home care services to maintain their independence and avoid costly nursing home placements. However, recent political developments threaten this stability. On May 11, House Republicans introduced a budget proposal aimed at cutting approximately $625 billion from Medicaid over ten years, which could significantly impact funding for In-Home Supportive Services (IHSS) workers.

While a complete overhaul of Medicaid remains unlikely, these proposed reductions raise concerns about their potential effects on Californians who depend on in-home care. According to health policy expert Larry Levitt, the cuts disproportionately affect California due to existing budget constraints, risking additional reductions in Medi-Cal and other state programs.

Although federal laws mandate certain Medicaid-covered services like nursing home care, they do not require states to fund home-based care for low-income seniors and disabled individuals. This leaves in-home services particularly vulnerable, especially as California had previously reduced funding for these programs following the economic downturn post-Great Recession. Lawsuits had temporarily halted some of these cuts, but court settlements led to subsequent reductions—8% in 2013 and an additional 7% in 2014.

California Governor Gavin Newsom's recent budget proposal on May 14 further trims IHSS funding by imposing weekly caps on provider overtime, reinstating an asset limit, and eliminating services for undocumented adults not already enrolled. He warned that federal Medicaid cuts could leave the state unable to offset lost federal funding, with nearly two-thirds of the $28.3 billion allocated for IHSS potentially at risk.

The uncertainty is causing widespread anxiety among recipients and their families. At a San Francisco meeting, Commission Chair Sascha Bittner expressed her concerns about the future of IHSS, highlighting the potential decrease in service hours for disabled individuals like herself. Nonprofit advocacy groups report a surge in inquiries from individuals seeking in-home assistance, many fearing that recent progress will be reversed due to funding shortages.

Local officials like Paul Dunaway from Sonoma County describe the situation as chaotic, with little clear information on the federal funding landscape. As the June 15 state budget deadline approaches, Californians face an uncertain future for in-home care programs, which remain vital to their independence and quality of life.

Source: https://medicalxpress.com/news/2025-05-californians-home-medicaid-independent.html