ANCOR Rebuts RFK Jr.’s Remarks On CDPAP, Home- And Community-Based Services

Why It Matters

The dispute underscores a clash between anti‑fraud policy drives and advocates defending a vital long‑term care model, with potential effects on Medicaid financing and the home‑care workforce.

Key Takeaways

• CDPAP serves 650,000 New Yorkers in home care
• RFK Jr. labeled consumer‑directed programs as Medicaid fraud hotspots
• ANCOR argues family caregivers often cannot replace professional support
• Politicized criticism threatens funding for home‑ and community‑based services
• Industry fears workforce shortages if caregiver roles are de‑valued

Pulse Analysis

Consumer‑directed personal assistance programs like New York’s Consumer Directed Personal Assistance Program (CDPAP) have become a cornerstone of Medicaid’s home‑and‑community‑based services (HCBS). By allowing eligible individuals to hire family members or chosen aides, CDPAP offers flexibility, promotes independence, and supports a labor market that now employs roughly 650,000 New Yorkers—the nation’s largest home‑care sector. Proponents argue the model fills gaps left by traditional agency staffing, especially for people with disabilities who lack nearby family support, while also generating wages for direct‑care workers who are often underpaid.

The program’s success, however, has attracted political scrutiny. In a recent Ways and Means Committee hearing, HHS Secretary Robert F. Kennedy Jr. warned that CDPAP and similar waivers are “rife with fraud,” suggesting that payments to family members are difficult for CMS to verify. This rhetoric echoes earlier Trump‑era attacks that framed consumer‑directed waivers as fraud hotbeds, a narrative reinforced by CMS Administrator Dr. Mehmet Oz’s criticism of New York’s Medicaid integrity efforts. While fraud does occur in any large cash‑flow system, analysts caution that sweeping accusations risk oversimplifying complex caregiving dynamics and may prompt blanket cuts that undermine essential services.

ANCOR, a national coalition of home‑care providers, pushed back, emphasizing that many families cannot provide adequate care and that de‑valuing paid and unpaid caregivers could exacerbate workforce shortages. The organization warns that politicized attacks may lead to reduced reimbursements, tighter eligibility rules, or program eliminations, jeopardizing access for vulnerable populations. As policymakers balance fraud prevention with the need to sustain HCBS, the outcome will shape the future of Medicaid’s home‑care infrastructure and the livelihood of millions of direct‑care professionals.