Congress Cut Medicaid. Guess Who Picks Up the Tab.

Roughly one in five Americans is caught between caring for a parent and raising a child. The Senate Special Committee on Aging will hold a hearing on May 13 to examine their situation — but the hearing comes after Congress already acted to make things worse. The One Big Beautiful Bill Act, signed as P.L. 119-21, cut Medicaid funding and added work requirements. As Legis1 reported, healthcare advocates warn the cuts will shift elder care burdens directly onto family members.

The numbers from the National Institutes of Health tell the story: 23.5 percent of sandwich generation caregivers report substantial financial difficulties, compared to 12.2 percent of non-sandwich caregivers. On the emotional side, 44.1 percent report significant difficulties, versus 32.2 percent of those without dual caregiving roles. These are not marginal differences. They describe a population absorbing costs the system has decided not to cover.

More than 600,000 people sit on waiting lists for home-based care under Medicaid, often for years. Two bills — the Home and Community-Based Services Access Act and the Long-Term Care Workforce Support Act — would make home care a guaranteed Medicaid benefit. Senator Marshall has introduced a separate bill to cover assisted living. These proposals exist. They have not moved. The policy contradiction is plain: Medicaid pays for 70 percent of home and community-based care in America, yet nursing home care is guaranteed while home care is optional. Families want to keep loved ones at home. Federal policy treats that preference as a budget line to cut.