‘Just cruel’: Medicaid halt in California and Minnesota plunges caregivers and disabled people into uncertainty

Published 3 August 2026 · us

By now, when Shannon Rosa hears about cuts to Medicaid and misinformation from the Trump administration about disabled people and their families, her predominant feeling

By now, when Shannon Rosa hears about cuts to Medicaid and misinformation from the Trump administration about disabled people and their families, her predominant feeling isn’t fear or sadness. It’s fury. “They don’t have any idea what they’re talking about,” she said. “I think they are very successful men who have never in their lives had to even consider what invisible labor looks like. They have no idea. They don’t know anything.” The Trump administration announced last month that it would hold back $867m in Medicaid funding for California, joining an earlier halt of $1.34bn – totaling $2.2bn in withheld payments to the state. Officials are also holding on to a total of $550m in Medicaid funding for Minnesota from the past three quarters. The amounts would cover services already paid by the states, for which the federal government normally partly reimburses them – creating a budgetary strain for the states, which have continued to cover Medicaid services despite the federal halt. “We suspect much of the questionable spending involves in-home services,” said Robert F Kennedy Jr, the secretary of the US Department of Health and Human Services (HHS), at a press conference announcing the halt. “Often these are services that your family would typically have provided for you that the federal government has started to fund,” said Mehmet Oz, administrator of the Centers for Medicare and Medicaid Services (CMS), alleging at the press conference that the program “can be abused”. View image in fullscreen Seniors protest against cuts to Social Security, Medicaid and veterans’ healthcare on 30 April 2025 in St Paul, Minnesota. Photograph: UCG/Universal Images Group/Getty Images In-home supportive services (IHSS), as they’re known in California, allow Rosa to take care of her disabled son without needing to work an additional job outside the home.

Rosa is also a senior editor at the Thinking Person’s Guide to Autism, an online resource hub that connects her with other families and autistic people. For many families, she said, the program is a lifeline, allowing them to provide care themselves or hire a caregiver for part of the day. If they lose that, families will be plunged into economic precarity, with caregivers forced to take on additional jobs while their disabled and ill family members go without care. “Without this, people become homeless. They lose their income. They lose their stability. Whatever tiny safety net they had is gone,” Rosa said. “It’s just cruel.” Home-based services have become “the flashpoint” in fraud accusations, said Andy Schneider, research professor of the practice at the Georgetown University McCourt School of Public Policy. But federal officials haven’t specified what exactly is fraudulent – a highly unusual way to approach such accusations, said Carl Tobias, law professor at the University of Richmond. “They’re just suspending the funds, and then shifting over to the states the burden to come in and prove that they’ve done everything possible to eliminate what the federal government said is fraud, but they haven’t shown much by way of proof of that,” Tobias added. “That part of it, I think, is new, and that’s what is so troubling.” Officials have pointed to an increase in home-based spending – but growth doesn’t equal fraud, Schneider said. More people want to be cared for at home than in the nursing home, caregivers need decent wages, and “the degree of disability in this population now requires more hours of personal care services”, he said.