""The federal Medicaid cuts are an absolute disaster for HCBS," said Sabrina Epstein, a policy analyst at Disability Rights California."
""People will be forced into nursing homes or left to rely on unpaid fa"
Emma Denice Milligan receives in-home personal care covered by Medi-Cal that enables independence and social activity. Under federal law, most home- and community-based services (HCBS) are optional benefits that states may include or limit. Congress approved roughly $1 trillion in Medicaid cuts beginning in 2026, and the federal government currently funds about 54% of California's HCBS costs. The budget changes raise the risk that states will reduce optional HCBS before protected services like nursing home care. Losses of HCBS could remove round-the-clock in-home support, push people into institutional care, or shift burdens onto unpaid family caregivers.
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