A Step Back for Home Health Aides? Proposed Rule Could Impact Wages and Overtime

The dedicated individuals who provide crucial home health care – helping our elderly, disabled, and ill loved ones live independently – are once again at the center of a federal policy debate. The current administration, through the U.S. Department of Labor (DOL), has proposed a rule that could significantly alter their pay and protections, with potential far-reaching effects.

What's On the Table?

At the heart of this proposal is a move to roll back a 2013 regulation that extended federal minimum wage and overtime protections to home health and personal care aides employed by third-party agencies. If the new rule is finalized, it would reinstate a broader "companionship services" exemption, essentially meaning many home care agencies would no longer be federally required to pay these workers the federal minimum wage ($7.25/hour) or provide overtime pay.

The Trump administration's DOL argues that this change is about deregulation. They contend it will:

Reduce "costly and burdensome" rules for home care providers.

Lower labor and compliance costs, potentially encouraging more providers and expanding access to care.

Increase scheduling flexibility for agencies.

While the DOL states that the median hourly wage for home health aides nationally is around $16-$17 (well above the federal minimum), they acknowledge that losing overtime pay could still significantly impact workers' earnings and morale.

The Deeper Impact: Minorities and Poverty

This proposed change raises serious concerns, especially for the communities these vital workers come from. The home health aide workforce is overwhelmingly comprised of women and people of color. Many are also immigrants, often working diligently to pull themselves and their families out of poverty.

For these individuals, federal protections like minimum wage and overtime are crucial safety nets. Removing them could:

Hinder Economic Mobility: Even if base hourly wages in some areas remain above the federal minimum, the loss of guaranteed overtime means workers could put in more hours for the same or less take-home pay. This makes it incredibly difficult to save, invest in their futures, or simply cover basic living expenses.

Exacerbate Disparities: Critics argue that the original "companionship services" exemption has historical roots in discriminatory practices that excluded predominantly Black and immigrant domestic workers from labor protections. Reinstating a broader exemption is seen by some as a step backward in addressing these historical inequities.

Recruitment Challenges: Even in High-Wage States

Consider a state like New York, where home health aides in places like New York City, Long Island, and Westchester are already making $19.10 an hour (as of January 1, 2025) due to state-mandated wage parity laws. At first glance, a federal minimum wage removal might seem irrelevant there.

However, even in states with higher wage floors, the loss of federal overtime protections could still create challenges:

Reduced Overall Pay: Agencies might restructure schedules to avoid overtime payments, or pay straight time for hours exceeding 40. This means less money in workers' pockets, impacting their ability to rely on this income.

Worsening Shortages: The home care industry already faces a severe national workforce shortage. If workers perceive a decrease in job stability, fair compensation, or overall respect for their labor, it could further discourage new recruits and increase turnover, making it even harder to find the caregivers our communities desperately need.

Ultimately, while the federal proposal aims to cut costs for providers, many fear it does so at the expense of an essential, yet often undervalued, workforce. The debate highlights the ongoing tension between business deregulation and ensuring fair labor standards for those who provide critical care in our homes.