States Boost Support for America’s 63 Million Caregivers

Despite tight budgets and partisanship, AARP has brought the growing needs of caregivers to the forefront of policy

Molly Snow,

AARP

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Published September 12, 2025

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What if America’s 63 million caregivers had access to extended family leave to take care of loved ones, more respite care to give them a break and financial flexibility that could ease the burden of paying for supplies and care?

With AARP’s support, a wave of state-level policy changes to backstop caregivers has been making those resources a reality, as lawmakers acknowledge the strain on those caring for loved ones.

This year, several states, including Vermont and Tennessee, expanded their job-leave programs to ensure caregivers don’t need to sacrifice income to take time for a loved one. Other states, like South Carolina, Ohio and Iowa, have given nursing home residents more financial flexibility to help pay for everyday needs.

And lawmakers in Maine and Wisconsin broadened eligibility for respite care programs this year, making it easier for families to afford part-time assistance and other services that support home-based care.

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“Momentum at the state level, I think, speaks to where the country is at broadly, even as partisanship at the federal level really makes progress difficult on a lot of those [initiatives],” says Jaimie Worker, senior director of policy and research at Caring Across Generations.

It’s not a moment too soon: Demands on caregivers have grown dramatically in recent years. The number of adults who provide ongoing care to adults or children with a medical condition or disability increased 45 percent over the past decade, according to the "2025 Caregiving in the U.S." report.

Caregivers are doing more than ever: They provide more complex care for longer periods of time with limited outside help. Nearly 70 percent of working-age caregivers have a job at the same time.

“It’s physically taxing, it’s emotionally taxing and, of course, socially taxing. It’s financially taxing,” says Mary Beth Malamatos, a caregiver for her 88-year-old mother in Florida. “There are stressors from all directions, and there’s no easy answer.”

Modernizing caregiving leave

In an effort to expand access to caregiving leave, several states have modernized their laws to make them more inclusive of nontraditional relationships between caregivers and care receivers.

This spring, Vermont expanded its benefit of 12 weeks of job-protected leave to include domestic and civil partners, grandparents and grandchildren and similar parent-child relationships.

“A lot of times, we have bills on the books that just aren’t equitable for today’s world, and so it excludes a lot of people,” says Vermont State Rep. Emilie Krasnow, the bill’s sponsor. “Our current unpaid family leave policies left people out that were in nontraditional family structures.”

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Colin Hilliard, AARP Vermont’s advocacy director, said it was important to support this effort, as protected leave provides peace of mind, especially for older Vermonters, who may feel pressure to retire early to care for a loved one.

“It doesn't do any good for folks to be losing their jobs for something like this,” he says.

Similarly, in Tennessee, AARP applauded a new law that grants state government employees six weeks of paid leave to care for a family member receiving hospice care. Eligible family members include a parent, spouse, child or grandchild.

“I think all of us would want to be able to have our family members by our side during some of those most challenging moments in life,” says Feroza Freeland, senior policy manager of the southern office at A Better Balance, a nonprofit legal advocacy organization.

Providing financial support

Caregiving for family members is often a full-time job, but most caregivers aren’t paid for this work. Many dip into their savings and other personal accounts to help cover costs for their loved one.

Recognizing the need to alleviate some of this financial stress, several states, including Iowa, Ohio and South Carolina, increased the personal needs allowance (PNA) for residents in Medicaid-funded nursing homes this year.

The PNA is money residents can spend on outside expenses, like cosmetics, clothes or a birthday card for a grandchild. It’s the amount nursing home residents on Medicaid can retain of their income; any income beyond that goes toward their care. In some cases, PNAs haven’t increased in decades; their value has been eroded by inflation over time.

“Imagine if after room, board and medical care, you only had $30 per month for personal expenses like your cellphone bill, haircut or preferred toiletries,” wrote researchers from Boston University and the University of Alabama at Birmingham in JAMA Health Forum, a peer-reviewed open-access journal.

Angela Van Pelt, of Iowa’s Office of the State Long-Term Care Ombudsman, says these modest increases enable residents to afford items that provide comfort and enhance well-being, even if family members don’t have money to spare.

“Increasing the [PNA] will empower older Ohioans in long-term care facilities to maintain dignity and independence as they age,” says AARP Ohio State Director Jenny Carlson.

Caregiver wellness

One in 5 family caregivers rate their health as fair or poor, according to the aforementioned 2025 caregiving report, and nearly a quarter say they have difficulty caring for themselves.

Many caregivers cannot afford to hire outside help, so some states have moved to expand access to grant funding that pays for short-term relief for caregivers so they can travel, tend to their own health or simply recharge.

After a two-year pilot, Maine updated and expanded its respite care program this year. The program offers grants that can be used for traditional respite resources like adult day services — but also for things like home modifications, medical equipment or investments in self-care, like gym memberships.

In Wisconsin, a new law lifted a $48,000 income cap for participation in its Alzheimer’s Family and Caregiver Support Program, “eliminating a barrier that has prevented many low- and middle-income families from accessing [it],” said State Rep. Dean Kaufert, who authored the bill.

The program provides financial support for home and community-based services like adult day, meal delivery and transportation, among others.

Federal efforts

Similar efforts to improve long-term care and strengthen support for caregivers are gaining traction among federal lawmakers, but progress has been slower.

“Caregiving brings real bipartisan agreement in Washington, because lawmakers know 63 million Americans are doing this work every day, and many also have caregiving experiences in their own families,” says Megan O’Reilly, AARP’s vice president of health and family. “But while there’s strong recognition, more action is needed.”

The federal spending law that President Trump signed on July 4 failed to include a nationwide tax credit for caregivers and delayed implementation of minimum staffing rules in nursing homes to protect patients and relieve health care workforce shortages. AARP advocated for the tax credit and the rules.

Looking ahead, one of AARP’s biggest legislative priorities is to secure direct financial relief for family caregivers through the federal Credit for Caring Act and the Lowering Costs for Caregivers Act.

Some states, including Oklahoma and Nebraska, have passed their own caregiver tax credits, while others initiated legislation this year to create one.

“States have helped lead the way, and it’s time for Congress to act so family caregivers aren’t left carrying the load alone,” says O’Reilly.

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Molly Snow is a writer for AARP covering advocacy issues and state news. She also writes AARP's Today's Tips podcast. She previously worked at other news outlets, including Federal Times, McClatchy and Gannett.