Ohio Medicaid Home Care Recipients Await Clarity as Program Changes Approach

For decades, Dorothy Valentine dedicated her career to caring for nursing home residents, an experience that shaped her view of long-term care. Today, at 80 years old and living with several chronic health conditions, she hopes to remain in her own home rather than move into a nursing facility.

Supported by her son, who serves as her full-time caregiver, Valentine receives home-based services through Ohio's Medicaid program. Like many of the nearly 140,000 Ohio residents who rely on similar assistance, she is closely watching potential changes to Medicaid as new federal policies begin to take effect.

The One Big Beautiful Bill Act, signed by President Donald Trump, includes significant Medicaid spending reductions over the next decade. Administration officials and many Republican leaders have said the reforms are intended to strengthen the program's long-term sustainability while ensuring taxpayer dollars are used appropriately.

Federal and state officials have also emphasized the importance of addressing fraud, waste and abuse within Medicaid-funded programs. They argue that stronger oversight can help preserve resources for individuals who genuinely depend on the program.

Earlier this year, acting U.S. Attorney General Todd Blanche and other administration officials highlighted several investigations involving alleged Medicaid fraud. Ohio Auditor and attorney general candidate Keith Faber has likewise called for increased accountability in home-care programs, arguing that stronger safeguards are necessary to protect both patients and taxpayers.

While policymakers discuss potential reforms, many families remain uncertain about how changes could affect services they currently receive.

Valentine says her greatest wish is to remain at home, where her son Clifford provides around-the-clock care. Because of her serious heart and respiratory conditions, he rarely leaves her alone for extended periods.

Ohio currently allows certain family caregivers to receive Medicaid support through waiver programs. However, Clifford said he has chosen not to apply because he is concerned additional household income could affect eligibility for other benefits.

Supporters of home-based care note that helping seniors remain in their homes often aligns with their personal preferences and, in many cases, may cost less than nursing home care. Studies have found that institutional long-term care generally carries significantly higher costs than many community-based alternatives.

Organizations involved in coordinating Medicaid services say home-based programs can also reduce hospitalizations by helping patients manage chronic medical conditions. They caution that any future policy changes should carefully consider both patient outcomes and long-term healthcare costs.

For the Trump administration and Republican lawmakers, however, the broader objective remains improving Medicaid's financial integrity while ensuring assistance is directed toward eligible beneficiaries. Officials have repeatedly stated that eliminating fraud and strengthening oversight are key priorities as the program continues to evolve.

For Dorothy Valentine, the issue is ultimately personal. After spending years caring for others, she hopes to continue receiving the support that allows her to remain in the place she calls home.

"This is where I want to be," she said. "If it wasn't for Cityblock, I don't know what I'd do."