Protect Medicaid HCBS: Smart Policy, Strong Communities
South Carolina’s House Ways and Means Committee has proposed cutting $27 million from the state’s funding request, jeopardizing critical services on an already overwhelmed system.
Statement from Able South Carolina, March 10, 2026
Medicaid Home and Community-Based Services (HCBS) are not fraud. They are essential services that allow disabled people and older adults to live safely in their homes and communities instead of being forced into institutions.
Recently, a troubling narrative has emerged suggesting that Medicaid HCBS is wasteful or fraudulent. This framing is dangerous and deeply misleading. Medicaid HCBS pays for basic, everyday supports such as personal care, help with bathing and dressing, meal preparation, transportation, and other assistance that many people with significant disabilities need simply to get through the day.
Without these services, many people would have no choice but to enter institutions such as nursing homes or Intermediate Care Facilities (ICFs). These settings are not only far more restrictive but also significantly more expensive for taxpayers than supporting people in their homes and communities. These facilities have also long been associated with higher risks of abuse and neglect, which is why our nation has spent decades moving toward community-based care.
Medicaid HCBS has long been supported by both Republicans and Democrats because it is the smarter and more fiscally responsible approach. Providing services in the community costs less than institutional care while allowing people with disabilities to work, go to school, raise families, and remain active members of their communities.
The current narrative is making it sound as if the supports that help disabled people get out of bed, eat, bathe, and live safely in their homes are somehow fraudulent. That is simply not true. Suggesting otherwise undermines public understanding and risks pushing people with disabilities out of their homes and back into institutions, something our country has spent decades working to change.
If fraud occurs anywhere in the system, it is far more likely to occur at the provider or billing level, within the institution itself, not with disabled people who rely on these services to survive. Disabled individuals should never be harmed or lose access to essential care because of failures in oversight or accountability in the system. The answer is stronger oversight of bad actors, not cutting the services people depend on to live.
Able South Carolina urges policymakers to reject misleading rhetoric and focus instead on protecting and strengthening Medicaid Home and Community-Based Services. HCBS is not a loophole or a scam; it is a bipartisan solution that supports independence, saves taxpayer dollars, and reflects our country’s commitment to community living.
At its core, this conversation is about whether disabled people have the right to live in their own homes and communities. Medicaid HCBS makes that possible. Undermining these services does not eliminate need; it simply shifts people into more restrictive and more expensive institutional settings.
Able South Carolina stands firmly with the disability community in defending Medicaid HCBS and ensuring that policies reflect what Americans across the political spectrum support: independence, fiscal responsibility, and the fundamental dignity of people with disabilities.
How you can help: ACT NOW to Protect Medicaid in South Carolina
South Carolina lawmakers are making decisions about the state budget right now, and Medicaid funding could be cut. The South Carolina House of Representatives will debate the budget the week of March 9, and they can still fix this problem, but they need to hear from you.
What Is Happening
The South Carolina Department of Health and Human Services asked the state for $203 million to keep Medicaid services running next year.
This request does NOT expand Medicaid or add new programs. It simply helps the state:
- Keep the services people already receive
- Pay required Medicare costs for people who have both Medicare and Medicaid
- Support Home and Community-Based Services that help people stay in their homes
Right now, the House Ways and Means Committee has cut $27 million from this request.
Why This Is a Problem
South Carolina already has over 20,000 people waiting for Home and Community-Based Services.
If Medicaid is not fully funded, it could lead to:
- Fewer healthcare providers accepting Medicaid
- Longer waiting lists for services
- People losing the supports they need to live in their communities
What You Can Do
Contact your state Representative and state Senator and ask them to fully fund Medicaid.
Tell them to support the $203 million Medicaid request.
Follow the link to complete our form to email your lawmaker. We have provided a pre-written letter, but we encourage you to add your own story about how this issue impacts you, your family, or those you care for. After you submit your email via our form, you will be taken to a page where you will be given the option to call your lawmaker using a script we have provided.