The massive tax cut bill President Trump signed in July is forcing states to grapple with a pivotal question: With federal Medicaid spending projected to drop drastically, which patients should get care at home, and how much care should they get?
In the United States, 3 million elderly and disabled people use home and community-based services, ranging from an hour or so a day up to around-the-clock help with various therapies, bathing, dressing, and other needs. States are not required to fund these programs, but many have chosen to use Medicaid funds to cover such care, accounting for two-thirds of all home care spending in 2022, according to a KFF analysis.
