What Donald Trump’s Medicaid cuts mean for caregivers
NPR 1A (podcast), September 30, 2025
Looking out for a family member who’s aging or disabled can take a huge toll on caregivers.
And the burden just got heavier thanks to President Donald Trump’s cuts to Medicaid — the single largest source of funding for long-term care of disabled and elderly people. It accounts for more than half of the roughly $415 billion that’s dedicated to these services each year.
A panel of experts to talk about what cuts to federal benefits mean for the caregivers who rely on them.
Guests
Kat McGowan
caregiver; journalist
Jason Resendez
president and CEO, National Alliance for Caregiving
Danilyn Rutherford
caretaker; president, Wenner-Gren Foundation for Anthropological Research; author, “Beautiful Mystery: Living in A Wordless World”
This is a summary of a 1A podcast episode discussing the impact of recent Medicaid cuts on caregivers in the United States. The conversation features host Todd Zwilich, Jason Resendiz of the National Alliance for Caregiving, journalist Kat McGowan, and Dannielynn Rutherford, a caregiver for her disabled adult daughter.
The Financial Strain of Caregiving
- High Costs: Caregiving for an aging, ill, or disabled family member carries a significant financial burden. AARP estimates that caregivers spend an average of $7,200 annually out-of-pocket and lose over $43,000 in income due to caretaking demands.
- Case Example: Dannielynn Rutherford, whose 25-year-old daughter Millie requires constant care, estimates the annual cost to be around $300,000 if caregivers are paid a living wage.
- Primary Funder: Medicaid is the single largest source of funding for long-term care in the U.S., covering over half of the $415 billion spent on these services annually. Crucially, Medicare does not cover long-term care, forcing many middle-class families to spend down their assets until they qualify for Medicaid.
Impact of Medicaid Cuts
- Scope of Reductions: The Trump administration’s budget will cut federal Medicaid spending by approximately $900 billion over ten years and add new work requirements.
- Reduced Services: States will likely respond to funding shortages by cutting optional services first, such as home and community-based care, respite care, and caregiver training. This pushes more people toward more expensive institutionalized care.
- Administrative Hurdles: New work requirements and increased paperwork will make it harder for caregivers and their loved ones to qualify for and maintain benefits. These administrative tasks are often compared to working a second full-time job.
- Fraud Misconceptions: While a caller expressed support for cutting fraud, data shows that only 2% of Medicaid fraud convictions are against beneficiaries; the vast majority are committed by providers like nursing homes and labs.
The Emotional and Social Toll
- Widespread but Isolating: While there are an estimated 63 million caregivers in the U.S., the role is often incredibly isolating. Over 60% of caregivers report high levels of emotional stress, anxiety, and depression.
- A Labor of Love: Despite the challenges, more than half of caregivers find a deep sense of purpose in their role. The goal is not to eliminate caregiving but to make it sustainable through better support systems.
- Lack of Public Dialogue: The speakers noted that unlike parenting, there is little public conversation about adult caregiving, which contributes to the stigma and isolation felt by many.
Potential Solutions and Next Steps
- State-Level Advocacy: With federal funding reduced, advocates must focus on state governments to create broad exemptions from work requirements and pass policies like caregiver tax credits and paid family leave.
- Increase Public Conversation: Raising public awareness is a crucial first step to reducing the stigma and isolation associated with caregiving.
- Organize and Collaborate: Care providers and families who benefit from the system must organize to find common cause and advocate for their needs.