California and New York lead the country in home health and personal care aide jobs
New York home care workers hit about 623 thousand in 2024 highest rate per senior in the US
California services for elderly and disabled added over 200 thousand jobs in recent years
These roles often account for 30 to 40 percent of total job gains in the states
Medicaid funds most of it through IHSS in California and CDPAP in New York
California IHSS serves nearly 900 thousand people and costs tens of billions
New York CDPAP grew 500 percent since 2017 and costs over 11 billion a year
Federal government deferred over 1 billion in Medicaid payments to California over growth and fraud concerns
Justice Department sued New York over a 10 billion home care program alleging sham deals
Programs let family members get paid which critics call carefare not real work
North of 50% of all "employment growth" in California and New York is fake home care fraud. https://t.co/J3ivRCN5VK pic.twitter.com/v02rGCPxOK
— Peter Kazanjy (@Kazanjy) August 19, 2026
Peter Kazanjy and nic carter spotlight how California and New York turned Medicaid home care into a massive job machine. The growth is real on paper but driven by federal dollars that look more like welfare transfers than market hiring.