Why It Matters

Tens of millions of Americans are quietly absorbing the costs of a fraying care system, paying out of pocket for aging parents while simultaneously raising children, and are a part of what is coined as the "sandwich generation." The Senate Special Committee on Aging's sandwich generation hearing, scheduled for May 13, brings that pressure into the Capitol at a moment when federal policy is actively making it worse. The One Big Beautiful Bill Act, signed into law as P.L. 119-21, included substantial Medicaid cuts that healthcare advocates warn will shift elder care burdens directly onto family members - the very people this hearing is designed to examine.

The stakes extend well beyond a single committee room. Roughly one in five Americans is estimated to be caught between caregiving for a parent and raising a child. Research published through the National Institutes of Health found that 23.5 percent of sandwich generation caregivers report substantial financial difficulties, compared to 12.2 percent of non-sandwich caregivers. Emotional strain follows a similar pattern: 44.1 percent report significant emotional difficulties, versus 32.2 percent of those not managing dual caregiving responsibilities.

The Policy Backdrop

The hearing lands against a backdrop of mounting concern about what Medicaid cuts mean for families already stretched thin. NPR reported in April 2025 that trimming Medicaid's long-term care payments "would be a major impact on the unpaid caregiving that is already filling in the gaps." The UC Berkeley Labor Center warned that Medicaid cuts threaten "not just [caregivers'] health, but the well-being of elderly and disabled adults who depend on them for care."

Fierce Healthcare reported that the signed law called for hefty federal reductions to Medicaid and new work requirements, with healthcare leaders "scrambling to reach out to patients who will be impacted." Economic Policy Research documented that proposed cuts could increase the share of older adults with unmet care needs, noting that "over three out of five adults aged 50 and older with functional limitations received no help" even before cuts take effect.

The financial picture for families managing both ends of the care spectrum is increasingly grim. A USA Today report published April 11, drawing on Care.com's Cost of Care Report, quoted CEO Brad Wilson saying that "parents are being pushed well beyond their limits by the demands of caregiving." An IndexBox analysis framed 2026 as a financial crisis year for the sandwich generation, documenting debt accumulation, high combined care costs, and serious career consequences for dual-generation caregivers. HousingWire reported that the share of Americans ages 40 to 60 who describe themselves as financially exhausted by parental caregiving has increased over the past three years.

Political Stakes

The hearing arrives with a substantial lobbying record on caregiving legislation, elder care, and childcare policy. AARP has been the most active organization in the space, with 43 filings in the past year and a lobbying presence focused on the Credit for Caring Act (S. 925/H.R. 2036), the Connecting Caregivers to Medicare Act, and the Lowering Costs for Caregivers Act. AARP has also separately lobbied on caregiver tax credit issues and the Credit for Caring Act, framing them as tools to offset the out-of-pocket costs that define the sandwich generation experience.

Genworth North America Corp. has invested $200,000 across four filings lobbying on the Well Being Insurance for Seniors to be at Home Act (H.R. 2082), a long-term care insurance bill that would directly affect how families fund aging parent care. The Home Care Association of America has pushed on multiple fronts, including the Ensuring Access to Affordable and Quality Home Care for Seniors and People with Disabilities Act (H.R. 2304).

On home and community-based services, Help at Home and the Partnership for Medicaid Home-Based Care have collectively filed more than $230,000 in disclosures focused on HCBS funding, which advocates argue is the most cost-effective alternative to institutional care for aging parents. The National Academy of Elder Law Attorneys has lobbied on HCBS, Medicaid, and the Older Americans Act Reauthorization, while the National Committee to Preserve Social Security and Medicare has specifically targeted the Older Americans Act Reauthorization Act (S. 2120), which it describes as "the major federal discretionary funding source for home and community-based services for older adults and their caregivers."

Paid Leave and Dependent Care

The child care side of the equation has attracted its own lobbying activity. Care.com has filed disclosures on the dependent care tax policy and the child dependent tax credit. The Society for Human Resource Management has lobbied on P.L. 119-21 provisions related to paid family and medical leave credits, the Child and Dependent Care Tax Credit Enhancement Act (H.R. 2994/S. 1421), and what it describes as the "Catching Up Family Caregivers Act." Prudential Financial has filed more than $1.6 million in disclosures that include paid family leave tax credit provisions. Paid Leave for All has filed $90,000 in disclosures focused on expanding paid family and medical leave, framing it as a structural fix for caregivers who currently have no financial cushion when a parent's health deteriorates.

Opposition to Medicaid Cuts

Several local governments have entered the federal lobbying arena specifically to push back on Medicaid reductions. Cook County, Illinois and Los Angeles County, California have each filed multiple disclosures explicitly opposing Medicaid cuts, including statutory Medicaid DSH cuts. Zero to Three has filed $180,000 in disclosures that directly cite P.L. 119-21's Medicaid cuts alongside child welfare and healthcare concerns, a framing that mirrors the dual-generation burden the hearing is designed to address.

The Hearing

The Senate Special Committee on Aging convenes on Wednesday, May 13. Sen. Rick Scott (R-FL) chairs the committee, with Sen. Kirsten Gillibrand (D-NY) serving as ranking member. Other committee members include Sens. Elizabeth Warren, Mark Kelly, Raphael Warnock, Angela Alsobrooks, Andy Kim, Tim Scott, Dave McCormick, Jim Justice II, Tommy Tuberville, Ron Johnson, Mike Crapo, Ashley Moody, and Jon Husted.

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