Testifying before the U.S. House Ways and Means Committee in mid-April 2026, Health and Human Services Secretary Robert F. Kennedy Jr. attacked Medicaid programs that pay family members to provide home care for elderly or disabled relatives. He claimed the programs compensate people for tasks they “used to do as family members for free” — including “balancing the checkbook, picking up the groceries, driving somebody to a doctor's appointment” — and called them “rife with fraud.”
More than 11 million Americans are paid through government home- and community-based services programs to care for family members who cannot live independently. The work, advocates say, often bears no resemblance to Kennedy's description.
Sue Root, a nurse and single mother of three in Colorado, is paid through Medicaid to care for her 25-year-old daughter, who suffered a catastrophic brain injury as a child and requires round-the-clock care including ventilator management, a feeding tube, and seizure monitoring. Root said: “The suggestion that family caregivers are simply running errands or performing typical normal tasks that should be done for free is not only inaccurate, it is deeply dismissive of the reality of special needs families like mine.”
Brandi Coon of Arizona, paid through Medicaid to care for her 11-year-old son with cerebral palsy and epilepsy: “Families like mine are not the problem. We are part of the solution.” Her Facebook post was shared more than a thousand times.
Kim Musheno, senior director of Medicaid policy at The Arc of the United States: “That's insulting. It's insulting to the families, and it's insulting to the work that direct support professionals do for people.”
Barbara Merrill, CEO of ANCOR: “They didn't just denigrate family caregivers, they denigrated the work of the professionals in our fields by suggesting that all home- and community-based services could just be done by family caregivers, and it should all be done for free. It's just shocking.”
Advocates do not dispute that fraud exists in large government programs and should be rooted out — state and federal prosecutors have secured convictions in recent years against operators who billed Medicaid for services that were never provided. But Kennedy's blanket framing risks undermining services 11 million Americans rely on. Medicaid home-care programs are already strained: more than 600,000 disabled or elderly people are on waitlists nationwide, and chronic worker shortages have led many states — with bipartisan support — to expand programs that pay family members directly.
Kennedy's comments come as states confront federal Medicaid cuts under the “big, beautiful bill” Trump signed last year. The HHS spokesperson defended Kennedy's framing, saying the programs “have long been vulnerable to misuse,” and the White House echoed that line.