As costs continue to rise for child and elderly care, “sandwich generation” adults — middle-aged Americans, 40 to 59 years old, who care for their children and aging parents — are already stretched thin. They’re juggling careers with caregiving, postponing retirement plans, draining emergency funds, and sacrificing their own mental and physical well-being to keep their families afloat. Now, Republicans are putting even more strain on families who are already at their breaking point.
Donald Trump and Republicans have slashed funding for Medicaid and the Affordable Care Act and ripped away the health care tax credits that kept coverage affordable, all to fund tax breaks for billionaires and big corporations. For many sandwich generation caregivers, that means paying hundreds or thousands more each year in premiums or out-of-pocket costs or risking going uninsured while they care for their loved ones. While middle-aged Americans shoulder the responsibility of caring for two generations, Trump and Republicans are siding with billionaires — and shifting the costs onto the middle class. Read more about Protect Our Care’s nationwide campaign “Technical Foul: The GOP’s Health Care Madness,” holding Republican lawmakers accountable for their devastating cuts to health care here.
Financial Toll of Caring for Children and Parents Leaves the “Sandwich Generation” Drowning. About 25 percent of Americans in the “sandwich generation” have reported providing financial support to both their parents and children. The average family spends 20 percent of their annual income on child care and those who are also caring for their parents experience an additional 17 percent squeeze. The time dedication for caregiving is also difficult to balance. On top of the average 50 hours a week of caregiving, people in the “sandwich generation” also often hold a full-time job. 57 percent of “sandwiched” caregivers feel like they have to choose between caring for their parents and their career. Two-thirds report having to reduce their work hours to part-time due to the financial, emotional, and mental exhaustion of care and nearly 70 percent have considered quitting their jobs entirely. This leads to dwindling long-term savings and increasing debt just to make ends meet. 70 percent of working adults in the “sandwich generation” say that their caregiving responsibilities have impacted their retirement plans, with over half stopping their retirement contributions to afford the financial burdens of supporting both their children and parents.
Republicans Are Cutting “Sandwiched” Caregivers’ Lifeline. When “sandwiched” caregivers have to give up their jobs in order to care for their parents, children, and loved ones, Medicaid’s long-term services and support (LTSS) programs pick up the critical role in helping these families stay afloat by compensating caregivers for the care they provide. 47 states and the District of Columbia have programs to provide payment to caregivers through Medicaid waivers or state plan options. These generally come in the form of hourly wages or daily stipends comparable to those of other direct care providers. These programs are commonly available to people caring for those with intellectual or developmental disabilities, seniors, and people with physical disabilities. However, Republicans passed the largest cuts to Medicaid in history, which will undoubtedly result in reductions in these programs. The implementation of these cuts will be devastating to families across the country that rely on LTSS programs to make ends meet while caring for an older or disabled family member. Cuts to Medicaid caregiver funding are already hitting the country:
- “Arizona families fear financial ruin, homelessness, as new disability care restrictions loom. New age-based limits blindside parents who quit their jobs to care for their disabled children.” [AZ Mirror, 9/11/25]
- “[Susan] Root is still figuring out what she’ll do if the caregiver cuts take effect. She’s a single mother, and the rate Medicaid pays to care for Amy is her primary source of income. Getting another job isn’t an option without someone else at home to manage her daughter’s health, and cutting her current income roughly in half isn’t going to work with the cost of living in Colorado Springs, she said.” [The Denver Post, 11/20/25]
The “Sandwich Generation” Is So Burnt Out From Caring for Others, They Can’t Care for Themselves. Over 70 percent of adults in the “sandwich generation” said managing caregiving responsibilities has taken a toll on their health. Caregivers tend to experience higher levels of depression and face increased feelings of isolation, with nearly 30 percent reporting they’ve considered self-harm or suicide. Over 50 percent feel as though they have no choice in being a caregiver. Caregivers can also be prone to burnout, causing them to avoid going to doctors’ appointments and delay treatment for health conditions. If burnout symptoms are left untreated, caregivers and the people they care for will experience a reduced quality of life and health decline.
Republican Work Requirements Will Rip Health Care Away From Caregivers. Republicans’ Big, Ugly Bill cut $1 trillion from Medicaid’s budget, ripping away health care from 10 million Americans, to bankroll tax breaks for the uber wealthy. An estimated 5 million Americans will lose coverage from a single provision in the bill: work requirements. Work requirements don’t result in more people working, just fewer people having Medicaid. 7.3 million people who rely on Medicaid identify as caregivers. Imposing work reporting requirements punishes them with onerous paperwork, adding an extra burden to their stretched workload that leads to families losing coverage, and money wasted on high administrative costs instead of health care. Work requirements are known to throw thousands of people off coverage regardless of whether they qualify for exemptions, including those for caregiving.
Republicans’ Ripped Away Health Care Tax Credits, Hiking Premiums for Millions of Caregivers. At the beginning of the year, Republicans ended the Affordable Care Act (ACA) health care tax credits, hiking premiums for over 20 million hardworking Americans and putting health care out of reach for millions. At a time when caregivers were already struggling to afford health care for both their children and their parents, families are facing doubling and tripling premiums and being forced to decide between putting food on the table, keeping a roof over their head, and affording health care coverage. One in three people who buy health care on their own are reducing their coverage and paying thousands more each year in health care costs.