A home health provider is completely pulling its services out of Alabama at the end of September and plans to lay off nearly 800 employees soon after, blaming the state’s inaction to expand Medicaid.

Help at Home informed the Alabama Department of Commerce of its upcoming closure and layoffs in a recent WARN notice, which major employers are legally required to file ahead of closures or layoffs.

Kristen Trenaman, spokeswoman for Help at Home, told AL.com that its Alabama operations will cease Sept. 30, when the company’s annual contracts with the state for services expires. The layoffs of 785 employees, which are scattered throughout every county in the state, are effective Nov. 4, she said.

“We are disheartened to leave the area we have served for many years, but take our responsibility to provide the safest, in-home personal care services to our clients very seriously,” Trenaman said in an email. “The current reimbursement and regulatory environment for Medicaid-funded home care has made it difficult to recruit, hire and retain workforce and we have not been able to overcome these challenges in the state of Alabama.”

Alabama is one of only 10 states that hasn’t accepted federal funding to expand its Medicaid coverage under the Affordable Care Act, and has some of the strictest income-based eligibility requirements in the country.

It’s been the subject of pushback from advocates and legislators, who point to an estimated 300,000 people who would gain Medicaid coverage through an expansion. So far, the state has blamed cost – an estimated $225.4 million per year – for its lack of expansion. Yet, in 2023 alone, Alabama passed up more than $2 billion in federal money for Medicaid.

Chicago-based Help at Home, which primarily provides services for elderly and disabled patients, has five main offices in Gardendale, Montgomery, Northport, Evergreen and Mobile. The company also employs field staff in all of Alabama’s 67 counties, and 10 of those counties’ contracts for services already ended a few months ago, Trenaman said.

Help at Home has operated in Alabama since 1975, per its website. Trenaman said that the company is working with the state and the AAA, a nationwide network on aging overseen by the federal government, to connect its clients and their caregivers with other providers or the state’s Personal Choices program.

The company will offer severance and retention packages to its full-time employees in Alabama, Trenaman said.

The company employs 53,000 caregivers who provide in-home care to 66,000 clients in ten other states, per its website.

Meanwhile, the company recently acquired two caregiving organizations in Ohio and Indiana, announced last month, and currently has nearly 3,000 open jobs across the country.

AL.com reporter Williesha Morris contributed to this story.