Are family caregivers exempted under Trump’s 'Big Beautiful Bill'? How Medicaid changes affect those who care for loved ones

Adults ages 19 to 64 who rely on Medicaid for health insurance will now have to meet new work requirements following the passage of US President Donald Trump’s 'One Big Beautiful Bill Act' (OBBA) in July last year. According to CNBC, one particular and important group which gets exemption is qualifying family caregivers. According to AARP data, cited by CNBC, around 7.3 million family caregivers ages 18 to 64 were on Medicaid out of 63 million total caregivers in the US in 2025.

The good news is that the changes will not take effect immediately and states have until January 1, 2027, to implement the new work requirements. According to recent AARP research, everything now depends on the way how states carry out these rules as it will be critical in ensuring that family caregivers keep uninterrupted access to Medicaid coverage.

As per AARP data, family caregivers enrolled in Medicaid provide an average of 35 hours of unpaid care each week. According to CNBC, family caregivers deliver an estimated $600 billion worth of unpaid care each year nationwide, underscoring their essential role in supporting loved ones and the broader health care system.

HOW MEDICAID CHANGES COULD IMPACT FAMILY CAREGIVERS

The OBBA introduces 'community engagement' or work requirements for Medicaid beneficiaries ages 19 to 64. These rules apply to people enrolled through Medicaid expansion programs created under the Affordable Care Act, which extended coverage to low-income adults in participating states. Supporters argue the policy may encourage employment and reduce federal spending, while critics warn that complicated reporting rules could cause eligible people to lose coverage.

According to the Congressional Budget Office, as quoted by CNBC, the law includes $911 billion in Medicaid cuts, with work requirements making up the largest portion, about $326 billion. Under the new rules, beneficiaries must complete at least 80 hours per month of work, job training, or other approved activities to keep coverage.

Family caregivers responsible for children age 13 and under, or for disabled individuals of any age, are exempt from these requirements. However, caregivers must prove they qualify for the exemption. As per AARP research, states can ease this process. To make it work effectively, the law has also set aside $200 million to help states implement the changes.