States Raise Home Care Aide Pay as Workforce Shortage Worsens

Several states have increased Medicaid reimbursement rates for home care aides as the industry faces a severe workforce shortage, with national median pay at $16.78 per hour ($34,900 annually) as of 2024. The U.S. will need over 5 million home care aides by 2034, up from 4.3 million today, to serve aging baby boomers — 4 million of whom turned 80 in 2026 alone. However, billions in Medicaid cuts taking effect in 2027 under the Trump administration's tax and spending law could force states to reduce home- and community-based services, since federal Medicaid law only mandates institutional care coverage. Ohio, where the population has aged rapidly since the 1990s industrial decline, illustrates the challenge: seniors who cannot afford private aides but do not qualify for Medicaid rely on area agencies on aging funded by local levies.

LTSS · Managed Care