Robert F. Kennedy Jr., the new Health and Human Services Secretary, has drawn sharp pushback from disability rights organizations and family caregivers after suggesting that Medicaid programs paying relatives to provide care are riddled with fraud and exploit public funds for work that families should do unpaid.
During House Ways and Means Committee testimony last week, Kennedy criticized the practice of compensating family members for caregiving tasks, singling out examples like "balancing the checkbook, for picking up the groceries, for driving somebody to a doctor's appointment." He alleged the federal government lacks adequate controls to verify whether paid caregivers actually perform their duties, calling the system "rife with fraud."
The remarks, which circulated widely on social media, triggered immediate backlash from advocates who said Kennedy mischaracterized caregiving as simple errand-running rather than the medically complex, round-the-clock work many families perform.
"That's insulting," said Kim Musheno, senior director of Medicaid policy at The Arc of the United States. "It's insulting to the families, and it's insulting to the work that direct support professionals do for people."
Sue Root, a nurse and single mother in Colorado who is paid through Medicaid to care for her 25-year-old daughter with a catastrophic brain injury, said Kennedy's characterization bore no resemblance to her reality. Her daughter requires around-the-clock supervision, medication management, a ventilator, feeding tube, and seizure monitoring that Root largely provides at home.
"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," Root said.
More than 11 million Americans receive government compensation to care for elderly or disabled relatives, according to recent data. The payments flow through state-administered Medicaid programs known as home- and community-based services, which reimburse both family members and professional caregivers to enable people to remain safely at home rather than in institutions.
Kennedy's criticism reflects growing conservative skepticism toward home-care programs, which have historically enjoyed bipartisan support as a cost-effective alternative to nursing homes. The administration framed the issue as one of fiscal stewardship. HHS spokesperson Andrew Nixon said home-care programs "have long been vulnerable to misuse," while White House spokesperson Kush Desai called waste and fraud "a drain on taxpayers" and "a threat to the long-term viability of these programs."
Advocates do not dispute that fraud occurs in large government programs. Prosecutors have secured convictions against operators who billed Medicaid for services never rendered or falsified records to inflate payments, sometimes totaling tens of millions of dollars. But caregivers argue Kennedy's broad accusations endanger programs millions depend on while overlooking the oversight mechanisms already in place. States typically require training, documentation of care, and other verification before compensating family members.
The timing of Kennedy's remarks comes as home-care programs face mounting pressure. More than 600,000 disabled or elderly people are on waitlists for services nationwide. Chronic workforce shortages driven by low pay and demanding conditions have prompted many states to expand programs allowing family members to serve as paid caregivers, a shift backed by both parties.
In rural areas and other regions where specialized home-care workers are unavailable, families say paying relatives is often the only practical solution. Musheno noted that families caring for people with complex medical needs frequently leave the workforce entirely. "How can they afford to live if they're not getting paid to take care of their child?" she said.
Brandi Coon, an Arizona mother paid through Medicaid to care for her 11-year-old son with cerebral palsy and epilepsy, responded to Kennedy's remarks with a Facebook post detailing her family's experience. Shared more than a thousand times, her post described how Medicaid pulled her family "out of financial and emotional crisis" while allowing her son to remain home. "Families like mine are not the problem," Coon wrote. "We are part of the solution."
Barbara Merrill, CEO of ANCOR, a national association representing disability service providers, said Kennedy's comments have left caregivers "gravely concerned" about the future of home care. She objected to what she called a false premise that professional caregiving work could simply be absorbed by unpaid family members.
The controversy arrives as states already grapple with budget strain and looming federal Medicaid cuts, pressures that are prompting some to consider restricting home-based services even before Kennedy's remarks gained attention.
Author Sarah Mitchell: "Kennedy's framing ignores the documented reality that family caregiving for medically fragile relatives is nothing like occasional errands, and his broad fraud allegations risk dismantling a system that already struggles to meet demand."
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