Minimum wage proposal leaves out home care workers and vulnerable Pennsylvanians

Gov. Josh Shapiro’s call to raise Pennsylvania’s minimum wage to $15 an hour reflects a widely shared goal: ensuring that hard-working Pennsylvanians can earn a livable wage. For many industries, increasing the minimum wage is a straight forward policy change, but for Medicaid-funded home care workers, the issue is more complicated and the governor’s budget proposal, as currently written, leaves them out entirely.

Home care workers are among the essential workers who make it possible for older adults and people with disabilities to remain safely in their homes. They assist with bathing, dressing, meals, medications, and other daily tasks that most of us take for granted. Without them, many Pennsylvanians would face unnecessary hospitalizations or be forced into nursing homes.

Despite their critical importance, most home care workers make less than employees at fast food restaurants. Their wages are largely determined by Medicaid reimbursement rates set by the state, and our elected officials from both sides of the aisle haven’t raised those rates in years.

Home care agencies already operating under razor thin margins cannot simply raise prices to cover higher wages, so the governor’s proposal must be paired with increased Medicaid funding.

The scale of this crisis is daunting and one of the reasons it hasn’t been addressed. The Home and Community-Based Services (HCBS) rate and wage study, commissioned by the Shapiro Administration and paid for by Pennsylvania taxpayers, was released in 2025, and it found that raising Personal Assistance Services wages to just $14.58 per hour would require more than $800 million in additional statewide investment.

Raising wages to $15 for a small portion (8%) of the workforce would still require $70M in new funding.

The same study concluded that many home care workers currently earn less than $15 per hour, not because of the minimum wage, but largely because Medicaid reimbursement rates have not kept pace with the labor market.

Pennsylvania currently reimburses for Personal Assistance Services at a rate 25-75% lower than every neighboring state: New York, New Jersey, Delaware, Maryland, West Virgina, and Ohio. This gap makes it even more difficult for home care agencies to compete for workers in an increasingly tight labor market.

The result is a workforce shortage that directly affects access to care. Across Pennsylvania, home care providers report that thousands of home care shifts go unfilled each month because there simply are not enough workers available. Seniors and families who depend on these services feel the impact immediately.

None of this diminishes the importance of raising the minimum wage. In fact, the home care sector strongly supports higher wages for the workers who provide this critical care, but policy alignment matters.

Previous proposals to raise Pennsylvania’s minimum wage were paired with Medicaid rate adjustments to ensure providers could meet higher wage expectations, but Gov. Shapiro’s proposal left out this critical change.

We’re urging the governor and legislators on both sides of the aisle to recognize this, because when wages and reimbursement rates both increase, the results are positive for everyone involved. Workers earn better wages.

Providers can recruit and retain high quality home care workers, and care recipients experience fewer disruptions and more reliable services.

When they move separately, however, the system becomes strained. Providers may face difficult decisions—reducing benefits, limiting overtime hours that many workers rely on for income, scaling back training investments, or withdrawing from regions where reimbursement is lowest. Ultimately, those pressures can translate into reduced access to care.

Pennsylvania has an opportunity to approach this moment thoughtfully. By aligning minimum wage policy with Medicaid reimbursement adjustments, the commonwealth can strengthen its home care workforce while advancing the broader goal of economic security for working families.

Source: PennLive