Recent cuts to Medicaid as part of President Trump’s extensive tax and spending plan have raised concerns for family caregivers. Experts warn that reduced access to healthcare for these caregivers and those they assist could result in heavier caregiving burdens.
According to the Congressional Budget Office, this package is projected to trim Medicaid spending by approximately $91.1 billion over the next decade, potentially increasing the number of uninsured Americans by up to 10 million.
The National Care Union indicates that around 8 million, or about 13%, of eligible U.S. family caregivers might lose their Medicaid coverage due to these cuts.
“We’re genuinely worried about the consequences these Medicaid reductions hold for family caregivers,” said Jason Resendes, president and CEO of the Alliance, during a press call earlier this week.
Changes to work requirements for joint and federal programs mean Medicaid recipients will now face more frequent eligibility checks. Currently, adults aged 19 to 64 are required to work or engage in community service activities for a minimum of 80 hours monthly to maintain eligibility for medical coverage through Medicaid.
Certain exceptions are in place for parents with dependents, those deemed “medically frail,” and individuals who are pregnant or postpartum.
Many caregivers find it challenging to work outside the home due to the intense demands of caring for their families or may only be able to work part-time, which makes it tough to meet Medicaid’s work requirements.
Lisa Tschudi, host of the “Love Don’t Pay the Bills” caregiving podcast, shared her experience: “We really didn’t have other options. I tried to find some sort of care for her while I worked, but it’s never quite worked out with a paid job.”
Her daughter’s epilepsy was difficult to manage during her childhood, requiring frequent medical appointments alongside daily caregiving.
“It was a lot to handle,” she mentioned.
With these new work requirements, some family caregivers may need to look for external help, which could present new costs and challenges.
“Even if external help is available, families often find these providers aren’t reliable,” noted Elizabeth Edwards, a senior attorney with the National Health Act Program. “Some of the contradictions in how people are seen as providers can complicate the situation.”
Family caregivers already spend significant time navigating bureaucratic obstacles, and these added job requirements will result in more paperwork to prove Medicaid eligibility.
Edwards highlighted that this extra administrative burden raises the risk of errors in the eligibility system, which could delay or prevent coverage altogether.
This has already affected many Medicaid recipients in Arkansas and Georgia, where work requirements were implemented, resulting in significant coverage losses. Over 18,000 people in Arkansas lost their Medicaid coverage within 10 months. Georgia also faces high uninsured rates.
“It’s not just the eligibility issues we’re facing; we have to navigate these extra barriers as family caregivers lose Medicaid coverage,” Resendes remarked.
Resendes noted that the U.S. has around 11 million family caregivers receiving payment for their services, mostly through home and community-based services and consumer programs at the state level. However, experts warn that funding for these programs could dwindle as states have to adjust to reduced Medicaid budgets.
“When states have less funding and must make choices, cutting home and community-based services often becomes a priority,” stated Resendes.
Tschudi, along with her husband and second daughter, is a paid caregiver benefiting from Oregon’s Medicaid program. Without this support, returning to unpaid caregiving would be financially unfeasible for her family.
“I wouldn’t wish that struggle on anyone,” Tschudi expressed. “It places families in a really untenable position when care isn’t compensated.”
