States including California, New York, Illinois and Texas have raised Medicaid-funded home care aide wages, with California's base now at $16.90 an hour and New York City's at $19.65. The moves respond to a worsening shortage: 4.3 million home care aides work today against a projected need of more than 5 million by 2034.
The 2024 national median pay for home care aides was $16.78 an hour, near the bottom of the U.S. wage scale, a problem compounded by the pandemic and immigration enforcement under the Trump administration. Federal Medicaid cuts taking effect in 2027, part of the tax and spending law Trump signed, threaten to erase these state-level wage gains by pressuring states to scale back home- and community-based services.
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