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A broken lifeline
When the Senate passed the sweeping Megabill that gutted Medicaid, it wasn’t just healthcare policy on paper—it was the quiet unraveling of a lifeline sustaining millions of American families. For Indian Americans like mine, these cuts hit especially hard. They threaten the values we hold dear: caring for elders with dignity, keeping family close, and ensuring our parents and grandparents age surrounded by love—not institutional walls.
My 100-year-old grandmother has lived with our family for decades, supported by home health services covered by Medicaid. Because of that help, four generations have shared in her life’s twilight years. Without it, the burden would fall squarely on my late mother, who battled metastatic cancer while caregiving for her; my uncle, who faces chronic illness in his seventies; and my aunt, now in her sixties. These are not unique stories—they are the heartbeat of Indian American families nationwide who honor their elders but depend on stable public supports to do so.
38 years of Indian American stories depend on what you do next. Stand with us today.
The Collapse of a Caregiving Compact
According to the Caregiving in the U.S. 2025 report by AARP and the National Alliance for Caregiving, there are now 63 million unpaid family caregivers across the country—one in five Americans. Roughly 6% identify as Asian American, many balancing cultural expectations of multigenerational care with the systemic challenges of healthcare access, including language barriers, health literacy, and lack of culturally-relevant home and community-based services. Among caregivers of older adults, 3 in 10 provide over 20 hours of unpaid care every week, often while working.
For Indian American households, where nearly 70% of older adults live with or near family members, Medicaid-funded home supports make it feasible to fulfill cultural duties without collapsing under the financial and emotional strain. The same AARP report notes that more than half of all caregivers report high emotional stress, and one in four experiences severe financial strain. Cuts to Medicaid add another layer of impossible choices: leave the workforce, sacrifice personal health, or place loved ones in understaffed facilities.
Undoing Decades of Progress
The new bill’s over $1 trillion in Medicaid cuts strike at the fragile infrastructure that sustains family caregivers—transportation to doctor visits, respite care, physical therapy, home health aides, and even necessities like dentures and eyeglasses. These services have kept aging Americans safe, independent, and at home.
It’s especially painful because the caregiver policy has finally begun to move forward. Bipartisan efforts, starting with President Trump’s RAISE Family Caregiver Act in 2018 and President Biden’s National Strategy to Support Family Caregivers in 2022, promised recognition and resources. These Medicaid cuts reverse those gains, eroding trust and placing millions back where we started—isolated and exhausted, bearing the weight alone.
The Human Cost
In Indian culture, elders are often regarded as the repositories of memory and identity. Caring for them isn’t a burden—it’s a blessing, a recognition that the aging bodies are repositories of a lifetime of wisdom. But blessings can’t replace broken systems. When policymakers pull the financial rug out from under caregivers, they force families to choose between jobs and aging parents, between living their American dream and living up to their dharma.
At 100, my grandmother still jokes with us, reminiscing about her childhood experiences in the early 1900s in pre-Independence India. She does that as she walks 10 rounds diligently after each meal on her rolling walker in the large bonus room at my uncle’s place. She is committed to connecting with each generation, communicating in broken English with her great-grandchildren, and delighting and laughing at their attempts to speak in Gujarati. The lack of Medicaid’s support now threatens these interactions at home.
As life expectancy grows and dementia prevalence doubles by 2040, the need for home and community-based care will explode. These cuts will do the opposite of what America needs: they will accelerate institutionalization, burnout, and despair.
Reclaiming a Shared Moral Ground
This shouldn’t be a partisan issue. Caregiving binds us all—across age, race, and politics. AARP data show that 75% of Americans want to age at home, but for that to remain possible, Medicaid must remain strong.
For Indian American families who see care as an act of love and legacy, this is not just a policy debate—it is our collective fight to preserve the meaning of home. This November, as we celebrate Family Caregiving Awareness Month, let’s urge our lawmakers to reverse these actions and restore faith in a promise America once made to its elders: that aging with grace is not a privilege, but a right.