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Policy in Motion
Hi there!
I’m Erna, the author of Care Fully.
My caregiver journey started over 20 years ago, when I was 21 years old. As a newly minted college graduate, my life was just beginning. I had no idea how to deal with the ups, downs, and in-betweens of caregiving for my Mother.
Care Fully is a play on words. The questions I am asked and the ones I still have drive each issue of this newsletter.
We “care fully” by balancing our needs as a caregivers with those we provide care for. My goal is to offer up experiences and information to support your caregiving journey.
This edition continues our focus on policy and caregivers. Caregiver policy represents the laws, budgets, and decisions made in rooms most of us will never enter.
During the height of my caregiving, policy felt irrelevant. I was struggling to make it to the next day, and didn’t have the bandwidth to follow legislation.
But, here’s what I’ve come to understand about policy. It is the difference between a caregiver who can access resources and one who cannot. Policy is the difference between a family who keeps their home-based care and one who loses it.
I am by no means a policy expert. My aim is to spark your curiosity. I hope that curiosity causes you to think about how your local and state officials act to influence change.
Thanks for your time.
If this edition was forwarded to you, please sign up for your own copy here. To spotlight or support caregiving in your company, email [email protected].
Today, we’re chatting about:
Medicaid complications.
Employer Leave Tax Credit.
Progress on state and federal bills.
YIKES: MEDICAID COMPLICATIONS
Medicaid funds home and community-based care for millions of older adults and people with disabilities.
The “One Big Beautiful Bill Act” (OBBA), signed into law on July 4, 2025, has some changes that will significantly affect those receiving Medicaid.
Over 7 million family caregivers receive aid through Medicaid, VA, and other state programs. Phased rollouts to work requirements, increased eligibility redeterminations, and rollbacks to Medicaid expansion are taking effect through 2027.
A February 2026 RAND study put the state-level price tag in sharper focus: state Medicaid budgets are projected to shrink by $664 billion through 2034 as the law’s provisions take effect. States will have to choose between cutting enrollment, reducing services, or backfilling with their own funds.
The OBBBA does include one important protection: family caregivers are explicitly exempt from the new work requirements. But the exemption doesn’t apply automatically. Each caregiver must prove they qualify.
States have until January 1, 2027 to implement the requirements. The manner in which they do it will determine whether millions of people receive the protection they’re legally entitled to, or lose coverage through paperwork alone.
ON THE BRIGHT SIDE: EMPLOYER PAID LEAVE TAX CREDIT
OBBA includes a federal tax credit of importance to caregivers. The credit incentivizes employers to offer paid family and medical leave.
This credit allows employers to offer leave after six months of employment instead of a full year. It was set to expire, but now applies permanently from the 2026 tax year and beyond.
Overall, this tax credit is a meaningful step for working caregivers with employers that choose to use it.
PROGRESS: STATE AND FEDERAL TAX CREDITS
Caregiver tax credits have spread beyond Oklahoma and Nebraska. Georgia, Missouri, Montana, New Jersey, North Dakota, and South Carolina have joined the fold.
These states enacted bills that offset out-of-pocket costs to support working family caregivers.
Also, the bipartisan Credit for Caring Act, reintroduced in 2025, would create a federal tax credit of up to $5,000 for working family caregivers to offset costs such as: adult day care, respite, and transportation. It has bipartisan support, but has not advanced to a floor vote in the Senate or House.
ROUNDING THINGS OUT . . .
Yes, much is happening. A lot of it isn’t in our control. But, here’s the thing, we can share links with our caregiving community to stay “in the know.” Some of us can make it a point to speak with or write our state representatives about these issues. That’s how change starts.
To help keep you in the know:
What else would you like me to feature in Care Fully? |
BEFORE YOU GO . . .
Do you know someone who could use Care Fully? Forward this newsletter to a fellow caregiver, colleague in HR, or policymaker in your network. The more folks who understand what is at stake and what is possible, the faster we can make change happen.
Until next time,
