Issue #3 · June 16, 2026
Nearly $100 billion in Medicaid funding is at risk, and families should be paying attention.
The biggest story for families right now is money, specifically the federal money that funds a huge share of home health and long term care in this country. New estimates show that federal Medicaid spending through what are called state directed payments has ballooned to nearly $100 billion a year across 41 states. That is an enormous number, and the federal government is now moving to set new limits that could significantly reduce funding flowing to states. If you are thinking "Medicaid isn't my concern because my parent has Medicare," hold on. These programs overlap in real and important ways, especially for the roughly 12 million Americans who are dually eligible for both Medicare and Medicaid. When Medicaid funding to states gets squeezed, the providers who care for our aging loved ones feel it directly.
At the same time, conversations about using artificial intelligence in healthcare are accelerating. A recent discussion featuring Dr. A.J. Blood, a cardiologist at Brigham and Women's Hospital, explored how AI could change the way patients get matched to new therapies and identified for clinical trials. For elder care, this kind of technology has real promise. Think about the potential for AI to help identify hospice eligible patients earlier or flag when a home health patient's condition is changing before a crisis hits. We are still in the early days, but the speed of development is worth watching closely.
Families should be keeping a close eye on their state's Medicaid budget over the next few months. With federal limits on state directed payments taking shape, many states will face difficult decisions about which services to cut or restructure. In practical terms, this could mean fewer home health aide hours, longer wait times for Medicaid funded home care programs, or changes to waiver programs that help seniors stay in their homes instead of moving to nursing facilities. States like California, Texas, and New York, which currently receive the largest shares of this federal funding, could see the most dramatic shifts.
If your loved one relies on Medicaid for any part of their care, now is a good time to talk with their care coordinator or the local Area Agency on Aging about what changes might be coming. Do not wait until services are reduced to start asking questions. Understanding your state's specific situation puts you in a much stronger position to plan ahead and explore alternatives if needed.
Let's talk about something that catches many families off guard: the difference between what Medicare covers for home health care and what Medicaid covers for long term home care. Medicare will pay for skilled home health services, things like nursing visits, physical therapy, and occupational therapy, when a doctor certifies that the patient is homebound and needs skilled care. But Medicare does not pay for the kind of ongoing personal care assistance that many aging adults need most, such as help with bathing, dressing, cooking, and getting around the house. That is where Medicaid steps in for people who qualify financially.
This matters right now because any reduction in Medicaid funding could directly affect the availability of those personal care services. For families currently paying out of pocket for home care aides, the national average cost runs between $27 and $33 per hour depending on your location. That adds up fast when someone needs help for several hours a day. If your family is trying to piece together a care plan, make sure you understand exactly which services are covered by which program. A common and costly mistake is assuming Medicare will cover custodial care at home. It won't. Knowing this upfront helps you budget realistically and avoid surprise bills.
Father's Day is this Sunday, and for many of us it carries a mix of gratitude, love, and sometimes worry about the people who raised us. If you are spending the day thinking about a father or grandfather who might need more support at home, know that you do not have to figure it all out alone. Best Hospice and Home Health is completely free for families, and we are here to connect you with verified hospice and home care providers in your area. Give us a call or visit our website whenever you are ready. And if someone in your life is struggling with these decisions, please pass this newsletter along to them.