Care Work in the Woodwork: Medicaid Home Care and Family Caregivers’ Health

Family caregivers provide the majority of eldercare in the United States, yet little is
known about how eldercare policy affects their health. For several decades, research has shown
that family caregivers experience emotional, physical, and financial strain that is associated with
worse mental and physical health. These harms are particularly severe for women, who are
overrepresented among family caregivers, provide more hours of more intensive care, and
experience worse associated declines in health. Simultaneously, U.S. eldercare policy has
undergone enormous change since the 1980s, as states have shifted Medicaid long-term care
spending from nursing homes to home care services. These policy changes have restructured the
social, political, and economic systems that shape the realities of family caregiving. However,
this dissertation is the first work to investigate how Medicaid home care affects family
caregivers’ health.