Abode and other nonprofits also use CalAIM funds to fill a critical gap often left by other grants: services for formerly homeless people living in subsidized housing. National programs such as Homekey fund the purchase and construction of homeless housing, with vouchers used to pay rent for tenants, but are essential to helping people with physical and mental health conditions and addictions. There are often no funds left to fund things like case management and counseling. The people Newsom made a priority in his efforts to clear encampments will continue to have housing.
“I shudder to think what would happen if, after meeting all the obligations from the development side to support people through coordinated entry and take in the truly vulnerable, we cut services to the bare essentials. ” Wang said.
What will President Trump do about CalAIM?
It’s hard to guess what the Trump administration will do with CalAIM. famous doctor Dr. Mehmet OzThe person President Trump has chosen to run the Centers for Medicare and Medicaid Services has no previous experience at the agency and therefore no track record to provide clues as to how he will operate.
Any changes will not be felt until late 2026, when California attempts to renew the CalAIM exemption. However, it is not unheard of for a president to end a waiver early. After President Joe Biden takes office in 2021, abandonedauthorized by President Trump, allowed states to require Medicaid recipients to prove they were working or unable to work. However, this was an extreme situation as multiple courts had already rejected these exemptions.
“CalAIM is not going away tomorrow or in January,” said Sharon LaPorte, director of California policy for the Housing Assistance Corporation. “But then I think the question is, what happens then? And the fact that it’s California and not President Trump’s favorite state is what makes people nervous. I think so.”
Plans to expand future coverage could also be at risk. Health insurance plans are being rolled out new framework Under CalAIM, we provide medical care to people in prisons and jails up to 90 days before release. California also has applied to amend and add one of the federal exemptions. rental assistance To services provided by CalAIM. If approved, states would be able to use Medi-Cash to pay up to six months of rent for homeless and at-risk people who are leaving prisons, prisons, hospitals, psychiatric inpatient settings, and other settings. will be allowed to use. or a substance abuse facility.
but, recent articles The Manhattan Institute, a conservative think tank, has questioned the use of health funds to pay for social services, suggesting the new administration may not support programs like CalAIM. It is a potential pioneer.
“Even if a social welfare program is well-intentioned and a smart idea, it does not make it a medical program,” wrote Chris Pope, a senior fellow at the Manhattan Institute. “Expanding the meaning of health care to cover the full range of social services will not significantly reduce health care costs, nor will it help distribute non-medical assistance to those who need it most.” It won’t be.”
The Trump administration could also change the waiver before renewing it, forcing California to reduce services provided by CalAIM or add work requirements.
Mr. Trump and the Republican-controlled Congress are likely to support requiring Medicaid recipients to prove they are working or unable to work. The last time he took office, Trump approved 13 state waivers, including work requirements, but the Biden administration later rescinded them. project 2025a conservative governance blueprint written by the Heritage Foundation, also prioritizes work requirements.
says that work requirements have historically led to people losing out on benefits, especially low-income people and people of color. the study By the progressive think tank Center on Budget and Policy Priorities. The study found that while many beneficiaries are working, they struggle to provide the necessary documentation to prove it, while full-time caregiver duties and lack of childcare Some people can’t work.
President Trump and Congress could also impose even deeper cuts to Medicaid overall, which could impact California’s ability to continue programs like CalAIM.
LaPorte said California could protect at least some of its CalAIM services by incorporating them into Medi-Cal as a permanent benefit. Her organization is asking the state to do that with CalAIM’s three housing services.
LA Care staff is already considering how they can continue to provide CalAIM services to their members if the Trump administration discontinues the program. Chief Medical Officer Dr Samir Amin said a major reorganization of funding would be needed. His organization has about 16,800 people enrolled in its CalAIM service, which helps people find and maintain housing.
“My concern is that the housing crisis in Los Angeles County didn’t happen overnight, and it’s not going to be solved overnight,” he said. “The reality is that it will take years of sustained effort and significant investment. And if we don’t make the necessary investments and have to re-prioritize some of these programs. , my concern is that these people will not be able to get the medical care they need because they don’t have housing.”
Staff writer Kristen Huang contributed to this story.
