The proposal to establish a soft cap of 56 hours per week for Personal Assistance (PA) services will not decrease the level of support individuals with disabilities need; therefore, it is unlikely to reduce overall Medicaid expenditures. Instead, it will likely shift individuals into higher costing waiver services that have higher reimbursement rates.

Nearly all alternative waiver services have a higher reimbursement rate than Personal Assistance, with In-Home Support Services being the most likely utilized service to replace PA, costing nearly twice as much. Families often cannot maintain full-time employment while providing care with only eight hours of PA per day. As a result, this proposed limitation could force families to seek more intensive, higher-cost waiver services to meet the same underlying needs.

Rather than reducing costs, the proposed soft cap could ultimately increase Medicaid expenditures while limiting families' ability to maintain employment and provide individuals with disabilities the support they need to remain safely in their homes.