What if IHSS were eliminated or greatly reduced?
If IHSS expenditures were to be eliminated, without any compensatory increase in nursing home expenditures, California would become the third lowest-spending state in the country, in terms of the proportion of its GDP spent on long-term care programs not specifically targeted to people with developmental disabilities. The current spending rate of 0.46% of GDP would drop by more than half, to 0.22%. And California would become the second least progressive state in its LTC policies, spending only 7.5% of its LTC dollars on non-institutional services. A large reduction in IHSS expenditures, short of eliminating the program, would make California appear somewhere along the diagonal line on the graph, no longer an average state in terms of overall expenditures, but instead much below average. It is very unlikely, however, that large cuts to IHSS would result in no increase in nursing home expenditures. These would almost certainly rise as people who had lost access to non-institutional serv
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