Disability advocates pushed back after top federal health officials suggested that Medicaid home and community-based services pay families for help they once gave for free. Disability Scoop reported the exchange on April 23, 2026.
What officials said, and how advocates responded
Testifying before Congress, HHS Secretary Robert F. Kennedy Jr. said waivers pay family members for tasks like balancing a checkbook, picking up groceries or driving to appointments. He called the arrangement "rife with fraud" and said CMS cannot verify that the work is done. CMS Administrator Mehmet Oz made similar comments in a social media video about personal care. ANCOR CEO Barbara Merrill called the remarks deeply concerning and said undervaluing HCBS demeans hard work by paid and unpaid caregivers. Katy Neas, CEO of The Arc of the United States, said broad claims of fraud put people with disabilities at risk of losing help, and that for many families a relative is the only reliable caregiver.
Why this matters for providers and DSPs
Paid family caregiving fills gaps left by the DSP shortage. Federal skepticism could bring new limits or verification rules, so agencies that employ family caregivers should keep documentation strong.