Home care
Medicaid home care faces budget pressure and worker shortages, report says
About 8.4 million people get Medicaid home and community-based services, and a Home Health Care News report says federal cuts, state budgets and staffing gaps are squeezing the agencies that serve them.
Key facts
- About 8.4 million people get Medicaid home and community services.
- Federal cuts and state budgets are adding pressure.
- Aide shortages persist.
What happened
Home Health Care News published a report on November 3 on Medicaid home and community-based services (HCBS), the programs that pay for aides and other help so people can stay at home instead of moving to a nursing home. About 8.4 million people receive these services, citing a Brandeis University report, and HCBS spending reached $286.5 billion in 2024, with Medicaid paying more than half.
The report says last year's federal budget law cut about $1 trillion from Medicaid over time, and a Boston College researcher noted that HCBS is often among the first areas states trim because it is optional under federal law. Providers described staffing shortages, including workers lost after Temporary Protected Status for Haitians ended in June, and said some states are cutting the number of authorized aide hours. A bill called the HCBS Access Act was introduced in August by two Democratic senators but has not passed.
What it means for families
If a parent relies on Medicaid home care, the number of approved hours or the availability of aides could change, so it helps to have a backup plan.
Families may see longer waits for a new aide, more turnover, or a reassessment that lowers hours.
New York has one of the country's largest Medicaid home care programs. If hours are reduced, you have the right to a written notice and to request a fair hearing.
What to do this week
- Keep copies of your parent's care plan and approved hours.
- If hours are cut, ask for the written notice and request a fair hearing quickly.
- List family members or other backups who can cover a missed shift.
Sources
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