Policy Changes Reshaping Family Caregiving | Age-Friendly Health Series

Why It Matters

Policy shifts in Medicaid funding and caregiver support directly affect the health of older adults and the economic stability of a workforce that increasingly balances employment with unpaid care responsibilities.

Key Takeaways

• Family caregiving now a bipartisan policy priority with rising legislative activity.
• HR1 proposes trillion‑dollar Medicaid cuts, threatening home‑care services.
• Work‑requirement rules could strip Medicaid from caregivers aged 50‑65.
• State innovations—paid leave, social‑insurance LTC—show viable caregiver support models.
• Federal ACL agency in limbo, staffing cuts hinder program implementation.

Summary

The Age‑Friendly Health Series podcast examined the rapidly evolving policy environment surrounding family caregiving, featuring host Katherine Ornstein and caregiving scholar Allison Baroff.

Baroff highlighted that roughly one‑quarter of Americans serve as unpaid caregivers, a role that now costs the economy about $1 trillion annually and has grown 50 percent in the past decade. Federal proposals such as HR1 would slash Medicaid funding by nearly a trillion dollars and impose work‑requirement conditions that could disqualify many caregivers, especially those aged 50‑65.

She cited concrete examples: Washington State’s social‑insurance long‑term‑care program, Oregon and California’s “missing‑middle” initiatives, and the recent passage of paid family‑leave laws in 13 states plus D.C., including Virginia. Baroff also warned that the Administration for Community Living (ACL) remains in limbo after staffing cuts and repeated congressional attempts to dissolve the agency.

The discussion underscores that while federal uncertainty threatens critical home‑care services, state‑level experiments and emerging private‑sector benefits are creating a patchwork of support that could inform future national reforms and protect the labor‑force participation of millions of caregivers.

Original Description

Welcome to our limited Age-Friendly Health podcast series. This is a multi-year series where each year, we will bring listeners episodes exploring topics at the intersection of aging, health, health care, and health policy.

In our third and final episode for the series in 2026, host Katherine Ornstein welcomes Alison Barkoff of George Washington University to the program to discuss the rising economic and social importance of family caregiving, recent federal policy shifts affecting Medicaid and caregiver programs, and new interventions at the state and private‑sector levels.

Support for the Age-Friendly Health series is provided by The John A. Hartford Foundation.

A Health Podyssey

Episode

May 5, 2026

★ Episode details: https://share.transistor.fm/s/d288dadb

★ Additional episodes: https://www.healthaffairs.org/podcasts