Washington, D.C. — Health and Human Services Secretary Robert F. Kennedy Jr. touched off a firestorm last week after calling Medicaid programs that pay family members to care for elderly and disabled relatives a breeding ground for fraud — and nursing homes are paying close attention.
During congressional testimony before the House Ways and Means Committee, Kennedy criticized home- and community-based services programs that compensate family caregivers, suggesting they pay people “for balancing the checkbook, for picking up the groceries, for driving somebody to a doctor’s appointment.” He said the federal government has no way to verify whether caregivers actually performed those duties.
“This is rife with fraud,” Kennedy said.
The remarks drew immediate backlash from disability rights advocates, caregivers, and provider groups who said Kennedy’s characterization bears no resemblance to what families actually do — and that cutting or undermining these programs could drive millions of people into nursing homes.
What’s Actually at Stake
More than 11 million Americans are paid through government programs to care for elderly or disabled family members, according to recent research. Many receive compensation through Medicaid’s home- and community-based services waivers — programs that have historically enjoyed bipartisan support precisely because they cost less than institutional care.
Kim Musheno of The Arc of the United States called Kennedy’s comments “insulting” to caregivers. “How can they afford to live if they’re not getting paid to take care of their child?” she said.
Advocates don’t dispute that fraud exists in large government programs. But they argue Kennedy’s framing sweeps in legitimate caregivers alongside actual wrongdoers — and risks creating a political climate that makes cuts easier to justify.
That’s the part nursing homes should be watching. Experts have repeatedly warned that rolling back home care availability would push more people into skilled nursing facilities — a system already struggling with Medicare Advantage prior authorization denials and coverage delays.
The Bigger Picture
Kennedy’s comments didn’t come in a vacuum. They land as Congress debates sweeping Medicaid cuts under budget reconciliation, and as several states have already begun paring back home- and community-based services ahead of expected federal reductions.
More than 600,000 people with disabilities are estimated to be on waitlists for home care services nationwide. If those waitlists grow, or if family caregivers lose funding, the overflow ends up somewhere — and that somewhere is often a skilled nursing facility.
HHS defended Kennedy’s remarks in a statement, saying home-care programs “have long been vulnerable to misuse.” The White House echoed the message, framing the scrutiny as protecting long-term program viability.
For nursing homes already stretched on staffing and Medicaid reimbursement, the question isn’t whether home care fraud exists. It’s whether the crackdown ends up solving that problem — or creating a bigger one.
Source: NBC News
