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To: Les H who wrote (51077)	1/23/2026 11:39:50 AM
From: Les H	Read Replies (1) \| Respond to of 51346

These 3 Policy Moves Are Likely To Change Health Care for Older People By Paula Span, Kaiser, January 23, 2026 A second rescinded regulation, this one more unexpected, brought about upheaval in July, when the Labor Department announced a return to a policy excluding home care workers from the federal Fair Labor Standards Act. Some history: Dating back to the New Deal, the FLSA mandated that workers receive the federal minimum wage (currently $7.25 an hour) and overtime pay. It exempted most “domestic service workers” until 1975, when a new Labor Department regulation included them — with the exception of home care workers. “There was a misinterpretation of home care work as being casual, nonprofessional, non-skilled,” the equivalent of teenage babysitting, said Kezia Scales, a vice president at PHI, a national research and advocacy organization. “Just someone popping into your mother’s house now and then and keeping her company.” For almost 40 years, workers and their supporters lobbied to change the rule, seeing it as a contributor to the low wages and meager benefits of a swiftly growing workforce, one made up primarily of women and minority groups, with many immigrants. In 2013, the Labor Department responded with a rule that brought home care workers under the labor act, entitled to minimum wage, time and a half for overtime work, and payment for travel time between clients. After industry lawsuits failed to overturn it, “everything settled down,” Scales said. “It was in place successfully for a decade.” Home care workers brought hundreds of compliance complaints annually. In 87% of them, the Labor Department found violations of the labor act, according to a 2020 Government Accountability Office report. Since 2013, home care agencies have paid about $158 million in back wages, PHI has calculated. Then in July, the Labor Department abruptly announced that it would return to the 1975 regulations and stop enforcing the 2013 rule, which it said “had negative effects on the ground” and hindered consumer access to care. The agencies employing most home care workers, primarily funded through Medicaid, would agree. “Many workers never got any benefit from this,” said Damon Terzaghi, a vice president at the National Alliance for Care at Home. “States made a lot of moves to essentially absolve themselves of any responsibility,” he said. A 2020 federal report, for example, found that 16 states had capped Medicaid-covered home care hours at 40, thus averting overtime payment. The alliance, which estimates that the number of impacted agencies and businesses has declined by 30% since 2013, supported the rescission. Scales, who hopes for congressional action, called it “a shocking step backward.” Where they concur is that the United States has never really committed to sufficiently funding long-term care at home. With the July legislation setting the stage for a $914 billion cut to Medicaid over the coming decade, that seems unlikely to change anytime soon. These 3 Policy Moves Are Likely To Change Health Care for Older People - KFF Health News The third policy move is that Traditional Medicare will use 'AI' to implement pre-authorization for certain treatments with the software providers receiving a cut of the 'savings'. That creates an incentive to deny coverage which is not unlike what's occurred with Medicare recently announcing a declining reimbursement schedule to hospices for palliative care, thus creating an incentive for them to withhold services from patients after 20 weeks to avoid being penalized by Medicare.