Discussions surrounding Medicaid are frequently simplified into political rhetoric focused on budgets, political disputes, and fraud. However, for millions of older adults and disabled people, Medicaid is not merely a policy issue; it allows them to live at home. It is the difference between living at home and being forced into a nursing home or institution. Simply put, Medicaid allows people to have independence.
This issue is deeply personal to me. Living with cerebral palsy, I have depended on personal care assistants since childhood. My personal care assistant helps me with daily activities—dressing, bathing, cooking, and other tasks that allow me to function. Without his support, I would be unable to live in my own apartment, pursue my goals, or be part of my community. For me, Medicaid is not just a government program — it allows me to live life on my own terms.
The media and politicians have drawn attention to the increasing fear among people and caregivers as the Trump administration intensifies scrutiny of home-based care programs and reduces funding.
Much of this apprehension revolves around Medicaid, which funds home and community-based services for older and disabled Americans. Medicaid also pays family caregivers. Family caregivers do so much, including providing highly skilled care such as wound care and tube feedings.
Simultaneously, federal authorities have increased efforts to prevent fraud. Mehmet Oz, who is the head of the Centers for Medicare & Medicaid Services, has strongly advocated for thorough investigations into hospice care, home healthcare agencies, and Medicaid-funded caregiving.
Vice President JD Vance and Health and Human Services Secretary Robert F. Kennedy Jr. have voiced concerns that fraud could jeopardize Medicaid’s long-term stability. In April, Robert F. Kennedy Jr. faced backlash after he said, “These are family members who are getting paid to do things that they used to do as family members for free. And this is rife with fraud, because we have no way at CMS to determine if they actually performed that duty or not.”
Conservative activist Christopher Rufo has echoed these concerns online, calling California’s In-Home Supportive Services program a “fraud magnet” and saying people receive pay for “cooking, cleaning, shopping, and watching television with family members.” Ruff also said social media users are encouraging people to quit their jobs in order to provide care. He says people can “collect up to $63,000 a year to stay home with family members.”
Unfortunately, this rhetoric overlooks the reality of caregiving. Across the United States, family caregivers provide an estimated trillion dollars’ worth of unpaid care annually. Family caregiving is highly skilled. Family caregivers do so much. They assist with things like showering, toileting, wound care, medication administration, and tube feedings.
Many juggle all of these responsibilities while working, raising children, dealing with financial stress, and managing their own health issues. Although caregiving can be fulfilling, it can be exhausting. To say that family caregivers are gaming the system undermines the important work they do every day.
A big concern is that anti-fraud measures could cut the very programs families depend on to survive. Home and community-based services are already underfunded due to critical staff shortages and long waiting lists—hundreds of thousands nationwide are desperately awaiting help. Cutting or eliminating these programs won’t eliminate fraud; it will eliminate essential care.
For policymakers, Medicaid might represent a line item or a political game. But for caregivers, older adults, and disabled people like me, it represents much more. It helps us remain in our homes, connected to our families and communities.
Sources:
Gonzales, Morgan. “ANCOR Rebuts RFK Jr.’s Remarks on CDPAP, Home- and Community-Based Services.” Home Health Care News, WTWH Media, 15 Apr. 2026, https://homehealthcarenews.com/2026/04/ancor-rebuts-rfk-jr-s-remarks-on-cdpap-home-and-community-based-services/.
Heasley, Shaun. “Family Caregivers Provide over $1 Trillion in Care Annually.” Disability Scoop, 13 Apr. 2026, http://www.disabilityscoop.com/2026/04/13/family-caregivers-provide-over-1-trillion-in-care-annually/31942/.
Hixenbaugh, Mike. “Families Caring for Disabled Relatives Face Unthinkable Choices as Medicaid Cuts Loom.” NBC News, 15 May 2026, https://www.nbcnews.com/news/us-news/trump-medicaid-cuts-threaten-caregivers-disabled-family-members-rcna344930.
Leys, Tony. “Trump’s Cuts to Medicaid Threaten Services That Help Disabled People Live at Home.” KFF Health News, 5 Mar. 2026, https://kffhealthnews.org/medicaid/medicaid-cuts-disabilities-home-community-based-services-iowa/.
Rufo, Christopher F., and Kenneth Schrupp. “Gavin Newsom’s $30 Billion Fraud Magnet.” City Journal, https://www.city-journal.org/article/california-in-home-supportive-services-program-fraud-gavin-newsom.