Article Summary –
Federal budget cuts supported by President Trump and congressional Republicans are jeopardizing caregiving programs by reducing funding for Medicaid, Medicare, the Affordable Care Act, and SNAP, which could lead to job losses for caregivers and a lack of essential services for vulnerable populations including the elderly, disabled, and children. States are struggling to maintain home and community-based services (HCBS) as nearly $1 trillion has been cut from Medicaid, with nearly 30 states proposing or enacting reductions in caregiving services since the One Big Beautiful Bill Act passed in 2025. Additionally, childcare workers, already facing economic insecurity due to low wages and limited benefits, are expected to endure further financial difficulties as a result of these federal cuts.
Federal funding reductions led by President Donald Trump and congressional Republicans are threatening caregiving programs nationwide. States are struggling to support caregivers facing job losses and the older adults, people with disabilities, and children dependent on these services, according to a new report from the Century Foundation.
The progressive think tank highlighted these issues in their July report titled, “Care Matters: A 2026 Report Card on Care Affordability and Access.”
The report emphasizes, “Investments in care meet needs across the lifespan, fostering dignity in living, learning, aging, and working.” However, the majority in Congress and the current administration have trimmed vital care program funding, coupled with a deregulatory agenda dismantling policies valuing care, using baseless claims against program integrity to justify further cutbacks.
Cuts to Medicaid, Medicare, the Affordable Care Act, and SNAP are included in the 2025 budget bill signed by Trump, feared to inflict lasting damage on the caregiving infrastructure. Vulnerable groups, including older adults and young children, face losing critical support, the report states.
Medicaid is the main funder for home- and community-based services (HCBS), which allow people with disabilities and older adults to get care at home instead of institutions. After a nearly $1 trillion reduction in Medicaid, multiple states are considering cuts to their HCBS programs, with some already reducing services.
Besides budget cuts, the administration has weakened and repealed policies that reduced childcare costs, protected homecare workers’ wages, and improved nursing home staffing standards, the Century Foundation reported.
Aging and disability care
Approximately 8.4 million people receive Medicaid-funded home or community services annually, according to the Bipartisan Policy Center. These services assist with daily activities like dressing and cooking for people with disabilities and older adults.
Access to this care has been challenging — with long Medicaid waiting lists — and Republican funding cuts worsen the limited availability, the Century Foundation highlights.
Following the enactment of the One Big Beautiful Bill Act by Trump in July 2025, nearly 30 states have initiated or enacted cuts to their care programs, reports an HCBS impact tracker by George Washington University.
Childcare and early learning
Childcare workers, already struggling before the cuts, earn low wages and often lack benefits. They rely on programs like SNAP and Medicaid, even with full-time employment, notes the University of California, Berkeley. These workers face severe financial strain from the federal cuts, according to the Century Foundation.
Fair working conditions
Care workers earn below the national median income. In 2025, childcare workers made $16.82 per hour on average, while the national median was $24.51. Home health aides’ average hourly wage was $17.21. These aides, also known as direct care workers, assist those with disabilities.
Care workers risk unemployment as many roles are funded by Medicaid.
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