Gavin Newsom’s Budget Plan Threatens Critical Home Care for 900,000 Californians

Julia Feinberg, a wheelchair user with spinal muscular atrophy, knows firsthand the value of California’s In-Home Supportive Services (IHSS) program. For years, she has relied on 600 hours of monthly assistance to perform daily tasks such as getting out of bed, grocery shopping, and meal preparation—allowing her to live independently in Oakland.

If Governor Gavin Newsom (D-Calif.) succeeds with his proposed budget changes, Feinberg and over 900,000 other disabled and aging Californians could lose the critical support they depend on. The IHSS program, active since 1983, provides home aides or family members with Medicaid-funded wages to assist individuals with disabilities in their homes.

How IHSS Works and Why It Matters

Funded by federal and state Medicaid dollars, IHSS enables disabled individuals to live in their communities rather than costly nursing homes or hospitals. As of March 2026, the program supports over 900,000 disabled people and aging adults across California. The arrangement benefits both consumers and state budgets, offering a cost-effective alternative to institutional care.

Newsom’s Proposed Changes Put Lives at Risk

Newsom’s budget proposal, first introduced in January, introduces two major threats to the IHSS program:

• County-Funded Increases: If a participant like Feinberg requires additional hours of care, counties—not the state—would be responsible for covering the full cost. Many counties lack the financial capacity to absorb these expenses.
• Cut to Backup Provider Program: Newsom also proposes eliminating a backup provider system, leaving disabled individuals vulnerable if their primary caregiver falls ill or is unavailable.

These changes come at a precarious time. The federal government, led by Donald Trump, is threatening to withhold over $1 billion in Medicaid reimbursements to California, alleging fraud without evidence. The dispute has placed California’s disabled population in the crossfire of a political standoff between state and federal leaders.

Advocates Decry Newsom’s Approach as Part of the Problem

Despite positioning himself as a leader in the resistance against Trump, advocates argue that Newsom’s budget proposals undermine his rhetoric. At the World Economic Forum in January, Newsom criticized other leaders for “rolling over” before Trump, stating, “I should have brought a bunch of kneepads for all the world leaders.”

“There is a difference between what [Newsom] is trying to project as the resistance or the antidote to Trump and the modern reality of the situation.” — Disability rights advocate

National Context: Medicaid Home Care Under Threat

California is not alone in facing these challenges. Home and community-based services under Medicaid are optional nationwide, leaving over 8 million disabled and older adults across the U.S. in a vulnerable position. States like California, which offer robust programs, are now scrambling to address draconian Medicaid cuts passed by Republicans at the federal level last year. The uncertainty has left millions questioning whether they will retain access to the care they need to live independently.