States slash family caregiver pay as Medicaid cuts loom
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- Maryland's Developmental Disabilities Administration proposed steep wage cuts for roughly 3,900 self-direction program participants this summer, with some caregivers facing pay reductions from about $47/hour to $29.98; the changes were slated for July 1 but delayed to October after disability advocate pushback.
- Idaho, Indiana, Missouri, and Colorado have also introduced 2026 proposals to dramatically slash pay for family caregivers, and Ohio legislators proposed banning family members from being certified caregivers before ultimately dropping the measure — all tied to the $1 trillion Medicaid funding cut in the 2025 GOP-backed tax bill taking effect January 1, 2027.
- Health Secretary Robert F. Kennedy Jr. said in April that Medicaid-funded programs paying family caregivers are "rife with fraud" and that caregivers are doing tasks they used to do for free; no data on fraud levels in self-direction programs exists, though the program's users doubled over the past decade to over 1.5 million per AARP.
- Kristine Fifer, who nearly went bankrupt in 2018 after Maryland cut her son Eddie's state-provided nurse when he turned 22, now says the new cuts will force her to either ride out foreclosure or institutionalize her son, who has cerebral palsy and requires around-the-clock care.
- Monique Duell, who cares for her nonverbal son Jeremiah with cerebral palsy, would see her pay cut from roughly $41/hour in 2024 to $29.98; she has accumulated nearly $40,000 in medical debt and said she cannot work outside the home given her son's care needs.
- The Maryland Department of Health did not explain the wage reductions or indicate whether cuts could be reversed, stating only that it is "committed to… supporting the health, safety, and independence of waiver participants"; a Baltimore Sun investigation found state lawmakers' claim that the budget had to be lowered was unsubstantiated.
- Disability advocates have personally lobbied officials at the Centers for Medicare and Medicaid Services and placed ads on barges traveling along the shoreline in Ocean City, Maryland, in an effort to halt the budget changes.
Why it matters: Roughly 3,900 Maryland caregivers and thousands more across at least four other states are staring at pay cuts of roughly $18–$20 per hour before the $1 trillion federal Medicaid cut even takes effect in January 2027, forcing families to choose between financial collapse and institutionalizing loved ones in facilities that advocates say face higher rates of abuse and neglect.
