Short answer: The federal Medicaid cuts signed into law in July 2025 will not directly cancel your child's Regional Center services. The Lanterman Act, California's state law guaranteeing services for people with developmental disabilities, remains in force. But more than a third of Regional Center funding comes from federal Medicaid, so the cuts create real budget pressure on California, and that pressure can reach your family indirectly through service rate changes, longer wait times, or new paperwork. The cuts mostly take effect between late 2026 and 2028, which means there is time to prepare.
Most of the parents who call us in spring 2026 are asking some version of the same question: is my child going to lose their services? They saw the headlines about a trillion dollars in Medicaid cuts. A friend at the autism support group mentioned that respite hours might be reduced. The service coordinator gave a careful, hedged answer that did not quite settle anything. They want a real answer, in plain language, without the political noise.
This article is that answer, as best as anyone can give it as of April 2026. Some of it is settled. Some of it is still in motion. We will tell you which is which.
What are the Medicaid cuts and when do they take effect?
The federal Medicaid cuts come from H.R. 1, the budget law signed on July 4, 2025, and sometimes called the One Big Beautiful Bill Act. H.R. 1 reduces federal Medicaid spending by close to $1 trillion over ten years, the largest cut in the program's 60-year history.
Most of the cuts do not take effect right away. The major changes phase in between January 1, 2026 and December 2028. The dates that matter most for families with a child on Regional Center services:
- October 1, 2026 — Some lawfully present immigrants lose full-scope Medi-Cal eligibility and keep only emergency benefits.
- December 31, 2026 — New Medicaid work-reporting requirements begin for some adult enrollees. California is already planning to auto-exempt the roughly 15,000 adult Regional Center consumers in the income-based Medi-Cal pathway.
- 2027 — Retroactive Medi-Cal coverage shrinks from three months to two months for most enrollees, and to one month for the expansion population.
- October 2028 — Higher cost-sharing kicks in for some Medicaid enrollees.
California's governor estimates the state will lose roughly $30 billion per year in federal funding once the cuts are fully phased in. That figure matters because it is the size of the hole the legislature will have to fill or absorb across all of Medi-Cal, not just developmental services.
How does Medicaid fund Regional Center services in California?
Federal Medicaid funds roughly 37% of California's Regional Center system. The Department of Developmental Services confirmed this number in its 2025-26 budget update: of the $18.7 billion spent on developmental services that year, about 37% came from the federal government through Medi-Cal, which is California's name for Medicaid.
The mechanism is technical but worth understanding in one sentence: DDS bills Medicaid for eligible services through the HCBS-DD 1915(c) waiver, a federal program that lets states use Medicaid dollars to pay for home- and community-based services for people with developmental disabilities.
The 2026-27 numbers are larger. California's proposed developmental services budget for 2026-27 is $21.1 billion, an increase of $2.4 billion (12.6%) over the prior year. The state expects to serve about 525,000 individuals across all 21 Regional Centers, an increase of 35,000. Roughly $7.8 billion of that $21.1 billion is the federal Medicaid contribution.
When federal Medicaid is cut, the federal portion of that pie shrinks. California then has to choose between two options: backfill the gap from the state General Fund, which is already projected to run a $2.9 billion deficit in 2026-27, or absorb the loss inside the developmental services system itself.
Does the Lanterman Act still protect my child's services?
The Lanterman Act still protects your child's services, and federal Medicaid cuts do not change that. The Lanterman Developmental Disabilities Services Act is California state law, passed in 1969. The Lanterman Act establishes a legal entitlement to services for people with developmental disabilities, which means services are not optional or discretionary. Regional Centers cannot deny eligible services based on cost alone.
As Disability Rights California put it directly in their July 2025 town hall: "The Lanterman Act will still be the law in California." Federal cuts to Medicaid do not have the power to repeal a state law.
What federal cuts can do is squeeze the state's budget hard enough that California passes its own laws to limit how the Lanterman Act gets implemented. This has happened before. During past California budget crises, the state placed temporary limits on certain services without repealing the underlying right to them. If California tries to do this again in response to H.R. 1, advocacy organizations including Disability Rights California have said they will challenge any limits that violate the Lanterman Act in court.
What services are most at risk of being cut?
The services most at risk of being cut are the ones funded through Medicaid waivers and described as "optional" under federal Medicaid rules, even when they feel essential to your family. Lanterman Act-protected core services are the most insulated. Optional or supplemental services are where state budget tightening usually shows up first.
| Service area | Risk level | Why |
|---|---|---|
| In-Home Supportive Services (IHSS) hours | Higher | The administration has already proposed IHSS cuts to address the H.R. 1 budget hole. About 150,000 Regional Center consumers also receive IHSS. |
| Provider rate increases planned for 2026-27 | Higher | The 10% quality-incentive piece on top of base rates depends on the state continuing to fund it through the budget cycle. |
| Self-Determination Program flexibility | Moderate | SDP is partly Medicaid-funded. The state has already added new oversight rules in 2025-26 that affected how individual budgets get developed. |
| Respite hours and day programs | Moderate | Respite is an HCBS waiver service. Optional under federal rules even when families depend on it. |
| In-home skill building | Lower | Core Lanterman entitlement. Most insulated from direct cuts, though provider availability could be affected if rates lag inflation. |
| Diagnostic evaluations and intake | Lower | Required by law. Wait times may grow if staffing tightens, but the right to evaluation does not change. |
The pattern across past California budget crises is consistent. The state limits how often a service can be used, who qualifies, or how providers get paid, before it ever touches the underlying entitlement. So a family is more likely to feel the cuts as a longer wait for a behavior assessment, a Self-Determination Program budget that gets harder to spend, or a respite provider who stops accepting new clients, than as an outright denial of service.
What should I do right now to protect my child's services?
The most useful thing you can do right now is build a paper trail and stay reachable. Most of the disruption that hits families in budget crises comes from administrative friction, not service denials. Families with organized records and active relationships with their service coordinator weather these periods better. If your child is not yet a Regional Center consumer, complete intake first. Intake is the foundation everything else sits on.
Confirm your child's Medi-Cal status this month
Call your county Medi-Cal worker and confirm your child is currently enrolled. Ask for the aid code and the renewal date. Renewal periods are getting shorter under H.R. 1 (six-month checks instead of annual ones for some groups), and a missed paperwork deadline is the most common way families lose Medi-Cal coverage.
Save every IPP, assessment, and service authorization
Your child's Individual Program Plan (IPP) is the document that establishes which services they are entitled to. Keep PDF copies of every version. Keep service authorization letters. Keep the assessments that justify the services. If a Regional Center later tries to reduce a service, the IPP is your evidence of what was determined to be necessary.
Ask your service coordinator three direct questions
Service coordinators are stretched thin and may not volunteer information unless asked. The three questions worth asking, in writing if possible:
- Which of my child's services are billed to Medicaid (or the HCBS waiver), and which are billed directly through the Regional Center?
- If the state announces budget changes during the next IPP cycle, what is the process for me to be notified and to push back?
- Is my child's IPP up to date, or do we need to add documentation before renewal?
Get on advocacy organization mailing lists
Disability Rights California, the State Council on Developmental Disabilities, and your local Area Board send out alerts when proposed budget changes are moving through the legislature. The alerts come with specific actions: a comment period to write into, a hearing to call about, a draft regulation to oppose. Family voices matter most during the legislative process, before changes are finalized.
How do I find out if my child's specific services are affected?
To find out if your child's specific services are affected, the most reliable path is your Regional Center service coordinator and the quarterly DDS budget updates. There is no central public database that flags which families will be affected. The system works case-by-case and through written notice, which is why the documentation in step 2 above matters so much.
Three reliable sources to check directly:
Disability Rights California — Proposed Medicaid Cuts The most thorough plain-language FAQ on what H.R. 1 means for Regional Center consumers, including a recorded town hall → California Department of Developmental Services — Budget Information Quarterly newsletters and budget updates from DDS, including direct messages to Regional Center consumers and families → Legislative Analyst's Office — DDS Budget Analysis Independent nonpartisan analysis of the DDS budget, written in plain language and updated as the legislature moves →If you would rather have a person walk you through it, your Regional Center has a parent rights advocate, and your local Family Resource Center can help interpret notices. Levi Life Skills works only inside the Regional Center system, so we read the same updates and we are happy to point families toward the right resource. Reach out if you need help reading a specific notice or letter.
The next two years for families will likely look like this: more paperwork, longer waits in some places, occasional changes to provider rates or program rules, and a louder advocacy environment. Your job, as a parent, is to keep your records organized, your service coordinator on speed dial, and your name on the right mailing lists. That is the version of preparation that actually helps when changes come.
The federal cuts squeeze the state budget. The state budget squeezes the Regional Center system. The Lanterman Act still protects your child's right to services. Your records protect your ability to defend that right.
Frequently asked questions
Will my child lose their Regional Center eligibility because of H.R. 1?
No. Regional Center eligibility is determined under the Lanterman Act, which is California state law. H.R. 1 changes Medicaid funding but does not change developmental services eligibility. Your child's eligibility is based on their qualifying diagnosis and assessed needs, not on Medicaid status.
Could my child still be on Regional Center services if they lose Medi-Cal?
Yes. Regional Center services are not means-tested under the Lanterman Act, and your child does not need to be on Medi-Cal to receive them. Medi-Cal status affects how the Regional Center bills for some services. It does not affect your child's right to receive them.
Are in-home skill building services Medicaid-funded?
In-home skill building is a Lanterman-protected service that the Regional Center may bill to Medicaid through the HCBS-DD waiver when the family is Medi-Cal eligible. The funding source for billing does not change the service itself or your child's right to it.
Will respite hours be cut?
Respite hours could be affected indirectly. Respite is an HCBS waiver service, and waiver services are more vulnerable to state-level budget pressure than core Lanterman entitlements. As of April 2026, no specific cuts to respite have been announced for 2026-27. Families should expect possible changes during the budget cycle and should track the DDS quarterly updates.
What about IHSS hours?
The Governor's 2026-27 budget proposed reductions to IHSS to help close the post-H.R. 1 budget hole. About 150,000 Regional Center consumers also receive IHSS, so this proposal affects many of our families directly. The legislature has not yet finalized whether the proposed IHSS cuts will pass.
Should I apply for new services before the cuts hit?
If your child has unmet needs that have not yet been added to the IPP, request an IPP meeting now rather than waiting. New services added during a stable budget cycle are easier to establish than new services added during a contraction. This is especially worth doing for assessments that have been on your list for a while.
