Help at Home Cuts Services and Lays Off 785 Workers Due to Medicaid Policy in Alabama

The layoffs will impact employees across all 67 counties in the state.


Home health provider Help at Home has announced the termination of its services in Alabama, effective September 30, with 785 employees facing layoffs effective November 4. The Chicago-based company attributed this decision to Alabama’s refusal to expand Medicaid, citing challenges related to reimbursement and regulation in the Medicaid-funded home care sector.

The layoffs will impact employees across all 67 counties in the state.

Alabama is one of 10 states that has chosen not to accept federal funding to expand its Medicaid coverage under the Affordable Care Act, maintaining some of the strictest income-based eligibility requirements in the nation. Advocates and legislators have argued that expanding Medicaid could provide coverage to approximately 300,000 individuals.

The state’s primary reason for rejecting expansion has been the perceived cost, estimated at $225.4 million annually. However, in 2023 alone, Alabama declined more than $2 billion in federal Medicaid funding.

Help at Home, an organization that offers services to elderly and disabled patients, has operated in Alabama since 1975, maintaining five offices across the state.

The company is working with both the state and the Administration on Aging, a federal government oversight network for aging, to assist its clients and caregivers in finding alternative providers. To support its affected employees, Help at Home intends to provide severance and retention packages to its full-time workers in Alabama.

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