For people living with complex medical conditions, in-home nursing care is lifesaving, not a luxury. It keeps patients safe, prevents medical emergencies, and supports families caring for loved ones with dignity. However, families are often forced to battle insurance companies to keep medically necessary care. Insurers claim patients are “stable” or family members can handle responsibilities once entrusted to trained professionals.
But many patients are stable because they receive consistent, skilled nursing. Removing this support destabilizes their health and increases preventable hospitalizations. Children with medical complexity illustrate this reality.
They make up a quarter of pediatric hospital days and forty percent of hospital charges. Data from the American Academy of Pediatrics shows they represented nearly sixty-three percent of pediatric hospitalizations, seventy-nine percent of pediatric hospital days, more than ninety-two percent of pediatric inpatient deaths, and over eighty-three percent of pediatric hospitalization costs, over $30.6 billion nationwide.
These numbers show why access to home nursing is not optional. Skilled care at home prevents medical crises. It also keeps children and adults out of the hospital.
In Minnesota, families caring for medically fragile children honestly, are experiencing the consequences of nursing cuts. Medica and HealthPartners stopped fully covering some around-the-clock nursing care, leaving families scrambling for alternatives. Chase Walter, who loves planets and exploring, relies on a feeding tube and tracheostomy, requiring constant monitoring. His family depends on skilled nurses to keep him safe.
Reese Erickson’s family faces similar challenges, with her ventilator requiring continuous oversight and nursing support essential to maintaining her health. Both families purchased additional insurance coverage because they understood the importance of consistent nursing care. But Medica and HealthPartners reduced coverage, arguing state law required only partial care. For Chase’s family, that meant going from 4,400 hours of nursing care per year to just 240 hours, barely three weeks of coverage.
Adults are facing the same battles. Patrick Tansey, who lives with Spinal Muscular Atrophy, relied on eighteen hours of skilled nursing daily for over a decade, crediting that care with helping him avoid hospitalizations. UnitedHealthcare reduced his coverage to six hours daily, despite his need for specialized respiratory treatments.
Kevin Kelly, who is quadriplegic, depended on 24-hour nursing care to manage medications and respiratory treatments. After UnitedHealthcare reduced coverage, his father was left providing nearly constant care on his own. These decisions have consequences far beyond paperwork. Families are forced into impossible situations, with parents and caregivers attempting to provide complex medical care while balancing work and their own health.
Cutting medically necessary home nursing is devastating for families and costly for the health care system. Children with medical complexity account for over $30 billion in annual pediatric hospitalization costs. Preventing avoidable hospitalizations through skilled home care protects patients while reducing unnecessary expenses. Behind every insurance decision is a person, a child who wants to learn, a young adult seeking independence, and a family trying to live together without constantly fighting for essential care.
Medical necessity should be determined by medical expertise and patient needs. In-home nursing care isn’t a convenience. It is what allows many people to remain safely at home, surrounded by loved ones, while receiving necessary medical support.
A healthcare system should measure success by how well it helps people avoid crises, not just respond to them. Supporting medically necessary home healthcare means giving patients the chance to live at home, with their families, and with the care that makes that possible. It preserves independence, protects health, reduces unnecessary hospitalizations, and honors dignity. And that’s what it’s all about, keeping patients safe, at home, and with the people they love.
Sources:
Gabbay, Jonathan M., et al. ‘The National Landscape of Hospitalizations for Children With Medical Complexity’. Hospital Pediatrics, vol. 16, no. 1, Dec. 2025, pp. e1–e7, https://doi.org/10.1542/hpeds.2025-008578.
Leyenaar, Joanna K., et al. “Hospitalizations by Children With Medical Complexity From 2009 to 2022.” Pediatrics, vol. 156, no. 2, July 2025, p. e2025071774, https://doi.org/10.1542/peds.2025-071774.
Littlefield, Susan-Elizabeth. “Minnesota Families Fight Health Insurance Company over Massive Disability Nursing Care Cuts.” CBS News Minnesota, 1 June 2026, https://www.cbsnews.com/minnesota/news/minnesota-families-fight-medica-health-insurance-disability-nurse-care-cuts/.
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CBS News
Rodriguez, Daniella. “Mineola Father Says UnitedHealthcare Deems 24/7 Home Care for Disabled Son No Longer ‘Medically Necessary.’” News 12 Long Island, 11 June 2026, https://longisland.news12.com/2026/06/11/mineola-father-says-unitedhealthcare-deems-247-home-care-for-disabled-son-no-longer-medically-necessary.
Rodriguez, Daniella. “‘This Is Wrong.’ Another NYC Employee’s Son Fights UnitedHealthcare over Slashed Nursing Care.” News 12 Long Island, 23 June 2026, https://longisland.news12.com/2026/06/23/this-is-wrong-another-nyc-employees-son-fights-unitedhealthcare-over-slashed-nursing-care/4gRLApqcJjP6Myf56NnEcH.
Simon, Tamara D., et al. ‘Children With Complex Chronic Conditions in Inpatient Hospital Settings in the United States’. Pediatrics, vol. 126, no. 4, Oct. 2010, pp. 647–655, https://doi.org/10.1542/peds.2009-3266.