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In the context of aging populations in OECD countries, public policies are encouraging the use of professional home care for the elderly living in the community. In the French context, this takes the form of subsidies financing the demand and public regulation of the home care sector. We study how the level of regulation in the home care sector relates to the use of formal care by the disabled elderly, using departmental variations to evaluate the determining factors of the use of formal care. We use an original survey on departmental practices alongside a national health survey ( Handicap Santé Ménages) to estimate the determinants of formal care use. When non-regulated providers—whose quality and price are poorly regulated—dominate the market, the elderly are less likely to use formal home care. This effect is concentrated on those aged sixty to seventy and vanishes for older individuals. Our results contribute to discussing both the questions raised by the decentralization of a national policy and the recent reform of the home care sector, increasing the level of regulation of the market. JEL codes: D12, H75, I18, J14