Massachusetts is one of the few States excluding spouses from receiving payments when they are the only ones able to care for their families. This policy unjustly excludes committed family members—often the most capable and culturally aligned caregivers—from critical support.

Vitra Health wants to change that.

The Cause

On July 1, 2025, Vitra Health’s CEO Lorena Silva and Chief Operating Officer Virginia Brackett testified before the Joint Committee on Health Care Financing in strong support of H.1394, S.886, and S.914 – An Act Relative to Spouses as Caregivers.

“These bills don’t create new entitlements — they correct an inequity in the system,” Lorena shared. “Today, non-spouse family members and friends can be paid as caregivers under MassHealth. Yet spouses — often the most present, willing, and culturally competent caregivers — are explicitly excluded.”

This outdated policy perpetuates a barrier to care, even as Massachusetts faces a dire caregiver shortage. More than 5,500 elder care recipients are currently on MassHealth waitlists, and 4,400 PCA hours go unstaffed statewide.

Passing these bills would allow spouses and legally liable family members to be paid caregivers under MassHealth, modernizing state law to meet today’s needs.

Who It Hurts

Imagine being forced to choose between financial stability and caring for your spouse. That’s the reality for many families in Massachusetts—particularly low-income families and women of color.

Cultural norms in Latino, Black, and immigrant communities often prioritize caring for loved ones at home. But current policy prevents the person closest to the care recipient—often a spouse—from receiving compensation, placing an unfair burden on families who already face systemic inequities.

“With a workforce that is over 70% BIPOC, Vitra Health understands the cultural importance of caring for loved ones at home” Lorena emphasized in her testimony.

“This issue is about more than cost. It’s about fairness and equity — and not intentionally leaving some ethnic groups without proper access to care.” – Lorena Silva

Cultural Competence Matters

Spouses are uniquely equipped to deliver care that respects language, culture, and deeply personal routines. As Lorena noted, “For many individuals with limited English proficiency, a spouse is not just the preferred caregiver — they are the only one who understands their language, culture, and needs.”

One Vitra Health client, Navea, knows this firsthand. After 35 years of marriage, her husband cannot be her paid caregiver.

“My daughter can only help part-time. If my husband could be part of the program, it would make a huge difference. He’s the one who’s with me the majority of the time.” – Navea

We encounter stories like Navea’s every day. Families deserve support—not obstacles.

The Bottom Line

The need is urgent. AARP reports that more than 53 million Americans, including 760,000 in Massachusetts, provide unpaid care to a loved one. Family caregivers are the foundation of our long-term care system, yet many do so without pay and at immense personal sacrifice.

“This isn’t unprecedented,” said Virginia Brackett. “Twenty-three states, including New Hampshire and Vermont, already allow spouses to serve as caregivers under Medicaid. So does the U.S. Veterans Administration. Massachusetts should not lag behind.”

“Let’s end an unjust exclusion. Let’s recognize the care already being provided. Let’s support our caregivers — and the families and communities who depend on them.” – Virginia Brackett

Vitra Health Supports Spousal Caregivers

Vitra Health’s CEO, Lorena Silva, and COO Virginia Brackett delivered a clear message: Vitra Health strongly supports H.1394, S.886, and S.914. We urge Massachusetts to take this step toward equity, compassion, and inclusive care.

Join us. Raise your voice for caregivers.

If you believe that spouses and guardians deserve the same support as other caregivers, here’s what you can do:

• Contact your legislators: Send a message or make a quick call. Let them know why these bills matter to you.
• Submit a testimony: A short personal story shared during public hearings can make a powerful impression.
• Join advocacy efforts: Groups like AARP Massachusetts and Dignity Alliance are already involved. Partnering with them can amplify your voice.
• Spread the word online: Share our blog, tag your state reps, and help build awareness in your community.

📚 Learn more: MassHealth Paid Caregiver Legislation for Families | Vitra Health