State lawmakers are considering ending Medicaid payments to people who help family members with personal activities such as keeping track of medications, preparing meals and showering. It’s part of a Republican-backed anti-fraud bill aimed at home health care providers. But disabled Ohioans and paid caregivers said it could be devastating.
Georgie Elson of Fairborn has had nine different personal caregivers in the last year. Her brother is now among those who are paid to help her with basic activities three days a week, in addition to his regular job. But if he can no longer get paid, she risks losing his help.
“That means I'm stuck in bed," Elson said in an interview. "That means I can't eat healthy food like. I'll have to eat chips or something that's beside me. Can't get up and do what I need to do, struggle to even just get all my meds.”
Erik Ware of Columbus is a paid caregiver for a family member, and he said he and the others who’ve been hired to provide care work as a team.
"We help each other out, and so he can have time off and I can have time off and the other caregiver can also have time off," Ware said in an interview. “It's a trickle-down system where we can help each other all out and take care of our client very accordingly.”
Fran Koenig of Medina cares for her adult daughter with Down syndrome. She isn’t paid but has friends who are compensated for providing care for family members.
“They can't get anybody in to do that work. It's not like they want to make money on this," Koenig said in an interview. "They're not going to get any help because it's hard to do that unless you're trained. I don't know that I could take care of my friend's children; some of them need feeding tubes and whatnot, and I'm not familiar with that sort of thing. And I don't think many people are unless you have a family member that is utilizing that sort of thing."
There are 7,000 people in Ohio who’ve gone through the waiver process to get paid by Medicaid for the care they provide to a family member in their home, making between $12 to around $18 an hour. After a report in the conservative news outlet the Daily Wire about hundreds of millions of dollars paid out by Ohio Medicaid to fraudulent home health care providers in 2024, some Republicans have said they’re suspicious that people being paid for providing care shouldn’t be.
“An able bodied 30-year-old man who's getting paid by the government to go visit his grandma or to cook dinner for his mom may not be illegal under our current system, may not be fraud. But it's waste. It's abuse," said Rep. Brian Stewart (R-Ashville) in the House Medicaid committee on May 27, in a question to the chief of the Health Care Fraud Section in the Ohio Attorney General's office. "I don't think it's what the overwhelming majority of Ohioans would consider to be a fair and worthwhile use of their tax dollars. And a reminder, we spend more money on Medicaid in the state than literally anything else."
A week later on June 3, the House Medicaid committee agreed to consider adding the ban on family members being paid by Medicaid to House Bill 795, an anti-fraud bill already under discussion.
“We will not be moving forward business as usual, when we have proposed up to 6 to $8 billion of fraud in our system," House Medicaid Committee chair Jennifer Gross (R-West Chester) said. "We need to stop. We need to stop those receiving care that should not be receiving care and we need to provide for those who definitely do need the care."
The Daily Wire’s report on widespread fraud and Ohio Medicaid came from data provided by the Department of Government Efficiency or DOGE, and the state hasn’t fully confirmed that. But it’s long been acknowledged that there is fraud in government programs, including Medicaid. Disabled Ohioans and their advocates say paid family caregivers are doing more than hanging out, and if they aren’t paid then families will need to hire other caregivers, when there’s already a shortage of such workers. And Koenig said they often need special skills that family members already know.
"It costs money to get somebody with training. It's not like you're getting your grandma from down the street," Koenig said. "When you have an adult child that is nonverbal, maybe, and needs a lot of help, where do you go for that? You know, you can't put an ad in the paper.”
It’s important to halt fraud, said Ware. But he said this ban isn’t fair.
"It really sucks that we're put in the same category as the people who don't follow the rules, and us who just want to take care of our clients, our family members, whoever it may be—and we're being seen as the bad guys as well," Ware said.
Elson agreed stopping fraud is critical, but she wants lawmakers to reconsider this.
“They need to slow down," Elson said. "We need to look at it very deliberately and carefully to make sure we're actually changing the fraud problem, while not having people lose care or even die from the repercussions of that."
The committee meets on Monday, and the bill is likely to be changed again. Medicaid committee member Jason Stephens wrote on X that the sudden introduction of the ban on paid family caregivers to HB 795 was "an ambush".
"This sub bill has provisions in it that totally blow up Medicaid in Ohio and will have the exact opposite effect of what we have been working towards," Stephens wrote, and closed his post by noting that he's a "no" on the bill.
Rep. Ron Ferguson (R-Wintersville) is also is on the committee, and was visibly affected by testimony from disabled Ohioans at the committee's meeting on June 3. He said in a text the bill will be changed and it's unclear what it will look like, but the bill in its current form has no votes.
