Nicole Jorwic on Caregiving’s Funding Crisis

Harry interviews Nicole Jorwic, Chief Program Officer at Caring Across Generations, about the challenges facing unpaid family caregivers and the paid direct care workforce. Jorwic explains that unpaid caregivers contribute about $1.1 trillion annually, while the largely female, heavily immigrant direct care workforce faces low wages, limited benefits, and unstable jobs—creating a system where care is both underpaid and unaffordable. She argues Medicaid funds over 70% of direct care wages and warns that the nearly trillion-dollar Medicaid cuts in the One Big Beautiful Bill Act, including work requirements, will increase red tape, strain state systems, reduce provider rates, and worsen waiting lists and caregiver burden. The conversation covers strengthening wages and career pipelines, adding a home care benefit to Medicare (“Medicare at Home”), making Medicaid home- and community-based services mandatory, and exploring payroll-tax models like WA Cares. Jorwic urges families—especially baby boomers—to start planning conversations and highlights CareConversations.com.   Topics 02:00 Who Provides Care 02:43 Caregiver Challenges 04:44 Medicaid Funding Squeeze 06:03 Congress Cuts Fallout 08:45 Work Requirements Red Tape 13:30 Strengthening Care Jobs 15:33 Supporting Family Caregivers 18:29 Paying Family Caregivers 20:15 Credits and Tax Relief 22:07 Future Workforce Crunch 24:15 Fixing the Cost Paradox 26:25 Three Leg Policy Plan 28:37 Public Support and Hope 31:00 Top Policy Priority 32:36 Start Care Conversations