CW: Fraud & Institutionalization
Nationwide, disabled people and older adults are increasingly worried as the federal government ramps up its efforts to cut Medicaid funding for home and community-based services. In California, over a billion dollars for In-Home Supportive Services was abruptly withheld.
Unfortunately, this is not an isolated incident. It’s part of a larger trend nationwide that threatens the independence, well-being, and dignity of millions of Americans who rely on these services to live at home rather than in nursing homes or institutional settings.
Mehmet Oz, who runs the Centers for Medicare and Medicaid Services, has become the public face of this effort. He has released videos, posted on social media, and issued formal statements stating that CMS is committed to preventing fraud within hospice care, home health, and other parts of the system. In January, CMS even said it could withhold $2 billion for 14 Medicaid services in Minnesota over the next fiscal year.
For many in the disability community, these actions don’t feel like they’re just trying to stop fraud. On the contrary, it feels more like a big attempt to cut services, while checking for fraud. This worry grew even stronger last year when a federal bill cut Medicaid funding by a trillion dollars over the next ten years, making states think about cutting home healthcare and other essential help for millions of people.
This isn’t just a local problem. More than 25% of Americans are disabled, and millions of them need home and community-based services to survive. When CMS talks about cutting state Medicaid funding, it puts people’s lives at risk nationwide.
Groups like the Disability and Aging Collaborative and the Consortium for Constituents with Disabilities have strongly criticized what CMS is doing. “We’ve been fighting to expand access to these services over decades and decades. It hasn’t been easy, but there has been bipartisan support for expanding these programs and services,” said Natalie Kean, federal health advocacy director at Justice in Aging. “To be constantly trying to defend what we have is exhausting.”
For me, this isn’t just an abstract concept. I have cerebral palsy, and I’ve relied on personal care assistants (PCAs) since childhood. My PCA helps me with things like going to the bathroom, getting dressed, bathing, cooking, and getting around – all basic tasks that let me live on my own.
Last month they cut my PCA hours. I then spent three weeks preparing an appeal, collecting documents, and really explaining why every single hour was important.
It was an exhausting process, and I am still waiting for my fair hearing. These kinds of cuts aren’t just some big policy decision. They change your daily life in ways that are frightening and upsetting.
What’s going on now is a civil rights issue across the country. It’s about whether disabled people get to live in their own homes, make their own decisions, and fully participate in their communities. When the federal government withholds funding from programs like IHSS or jeopardizes Medicaid services, it means that the freedom of disabled people in the U.S. is threatened. The disability community has fought for too long and too hard to let policies that consider our lives line items hold us back.
What’s at stake is pretty clear. This isn’t just about one state. It’s about the future of home and community-based services. It’s about whether our country will respect the right of disabled people to live in the community, or if we will go back to a time where people are forced into institutions and nursing homes because the help they need at home has been taken away.
Sources:
Broderick, O. Rose. “As Trump Administration Cracks down on Health Care Fraud, People with Disabilities Feel Singled Out.” STAT, Boston Globe Media , 18 Mar. 2026, http://www.statnews.com/2026/03/18/trump-health-fraud-crackdown-disability-concerns/.
Laughlin, Jason. “MassHealth Is Losing Billions. Cuts May Be Guided by Those It Serves .” The Boston Globe, Boston Globe Media , 5 Mar. 2026, http://www.bostonglobe.com/2026/03/05/metro/masshealth-pca-program-cuts-trump/?
Maniates, Hannah. “Why Did They Do It That Way? Home and Community-Based Services.” National Association of Medicaid Directors, National Association of Medicaid Directors, 16 Apr. 2024, medicaiddirectors.org/resource/why-did-they-do-it-that-way-home-and-community-based-services/.
Rector, Kevin. “Vance Says $1.3 Billion in Medicaid Payments to California Will Be Deferred over Fraud Concerns.” The Los Angeles Times, Los Angeles Times Communications LLC, 13 May 2026, http://www.latimes.com/california/story/2026-05-13/vance-says-1-3-billion-in-medicaid-payments-to-california-will-be-deferred-over-fraud-concerns.