Article Summary –
Federal budget cuts enacted under President Trump and congressional Republicans have significantly reduced funding for key caregiving programs, such as Medicaid, Medicare, and SNAP, threatening the jobs of caregivers and the well-being of the vulnerable populations they serve, including older adults, people with disabilities, and children. The Century Foundation’s report highlights that these cuts, along with a deregulatory agenda, undermine the nation’s caregiving infrastructure, leading several states to consider or implement cuts to essential services like home and community-based services (HCBS). Additionally, childcare workers, who already face low wages and economic insecurity, are likely to experience further financial strain due to the rollback of government support programs they rely on, exacerbating their precarious working conditions.
Federal budget cuts backed by President Donald Trump and congressional Republicans are threatening caregiving programs nationwide. States are scrambling to support caregivers who risk losing jobs, along with the vulnerable populations reliant on their services, according to a new Century Foundation report.
The progressive think tank released the report, “Care Matters: A 2026 Report Card on Care Affordability and Access,” in late July. “Investments in care address needs across the lifespan, enabling people to live, learn, age, and work with dignity,” it states. However, Congress and the administration have cut funding for essential care programs while promoting deregulatory measures that undermine policies valuing care, claiming program integrity concerns to justify further disinvestment.
Significant cuts to Medicaid, Medicare, the Affordable Care Act, and SNAP are embedded in the 2025 budget bill signed by Trump, potentially damaging the caregiving infrastructure. Vulnerable groups, including older adults and children, face losing vital support, the foundation warns.
Medicaid funds home- and community-based services (HCBS), allowing seniors and disabled individuals to receive at-home care instead of institutional care. After Republicans’ nearly $1 trillion Medicaid cut, some states are considering cuts to HCBS, while others have already done so.
Beyond budget cuts, the administration has weakened policies reducing childcare costs, protected wages for homecare workers, and improved nursing home staffing, according to the Century Foundation.
Aging and Disability Care
Every year, about 8.4 million people benefit from Medicaid-funded home or community services, reports the Bipartisan Policy Center. These services assist with daily activities like dressing and cooking for disabled and older adults. However, the longstanding challenge of access is worsening under Medicaid waiting lists, exacerbated by Republican healthcare funding cuts.
Since the enactment of the One Big Beautiful Bill Act in July 2025, nearly 30 states have proposed or enacted cuts to home and community care, as tracked by the HCBS impact tracker from George Washington University’s Milken Institute School of Public Health.
Childcare and Early Learning
Childcare workers faced low wages and often no benefits even before these cuts. They frequently rely on government programs like SNAP and Medicaid for necessities, reports the Center for the Study of Child Care Employment. Federal program cuts may cause substantial financial harm to these workers, as noted by the Century Foundation report.
Fair Working Conditions
Care workers typically earn less than the national median income. In 2025, childcare workers earned an average of $16.82 per hour, while the national median was $24.51. Home health aides earned $17.21 per hour, often working as direct care workers assisting individuals with disabilities. Many care workers face job losses as their positions are often Medicaid-funded.
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