States Boost Support for America’s 63 Million Caregivers

Last spring, Vermont expanded its benefit of 12 weeks of job-protected leave to include domestic and civil partners, grandparents and grandchildren and  adoptive- or foster-parent 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.”

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 AARP applauded a Tennessee law passed last year 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. ​AARP also helped defend family leave programs from budget cuts in Washington, D.C., where local policymakers unsuccessfully sought to reduce the benefit for District employees from eight weeks to just two.

And in March, Virginia’s legislature passed a bill giving most employees 12 weeks of paid leave for their own medical needs or to care for a family member.

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 a loved one's costs.

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

The PNA is money residents can use for 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, and inflation has eroded their value 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. 

States have also used their budgets as a vehicle to boost support for home services. Thanks to strong advocacy in Wyoming, the governor signed a bill March 3 that increases funding for home- and community-based services (HCBS) and addresses lengthy waitlists for families seeking care at home — often a more affordable alternative to assisted living or nursing homes.

South Dakota also approved funding increases in its 2026 state budget for HCBS and long-term care. 

Caregiver wellness

One in 5 family caregivers rate their health as fair or poor, according to the 2025 “Caregiving in the U.S.” 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 last 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 programs, meal delivery and transportation. 

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 suspended implementation of minimum staffing rules in nursing homes to protect patients and ease these facilities’ workforce shortages. AARP advocated for the tax credit and is backing new legislation introduced in February to restore these staffing standards.

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; others initiated legislation last year to establish similar tax breaks. 

Since January, AARP has also championed proposed caregiver tax credits that are gaining support from lawmakers in Hawaii, Connecticut, Michigan, Massachusetts and West Virginia.

“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.