The job you already have

The daughter of Vietnamese immigrants who filed her family's Medicaid paperwork at nine has built a $225 million company on a rule most families never hear about: in some states, Medicaid will pay a family member to provide the care they are already providing.

Abby Care operates in eight states. Caregivers become W-2 employees, get trained at no cost, and are assigned a nurse who takes their texts. Forbes named it one of 2026's likely unicorns.

The part worth carrying is that the rule is not Abby Care's. Paid family caregiving runs through state Medicaid waivers, and the programs, the names, and the eligibility rules differ everywhere. Most families who would qualify never find out, because telling them is nobody's job.

Nguyen's argument against proposed cuts is the one to remember. Families without support do not stop needing care. They move a loved one into a nursing home, and Medicaid pays more for that.

If you are giving care unpaid, the question for your state Medicaid office is whether a self-directed or family caregiver program exists where you live.