How the National Alliance for Caregiving Advocates for Family Caregivers in Policy

The National Alliance for Caregiving (NAC) advocates by combining research, coalition-building, and direct engagement with federal rulemaking and legislation. Its policy work shows up in four main forms: formal comments on proposed federal rules, public statements and endorsements of legislation, coalition partnerships such as the Caregiver Nation Coalition, and policy briefs and reports that translate caregiver data into recommendations for decision-makers. This explainer covers each channel, using NAC's own published activity as the reference point.

Commenting on Federal Rules

When a federal agency proposes a rule, it opens a public comment period. NAC uses that window to submit formal responses on behalf of family caregivers.

A documented example is its response to the CY 2027 Medicare Physician Fee Schedule Proposed Rule, released by the Centers for Medicare & Medicaid Services (CMS). NAC and the Caregiver Nation Coalition responded jointly — a signal that the comment was coordinated across multiple organizations rather than filed by NAC alone.

How this works as an advocacy mechanism:

1. Input: CMS publishes a proposed rule in the Federal Register and invites public comments.
2. Action: NAC reviews the provisions that touch caregivers — payment for care coordination, training, or services delivered in home settings — and files a written response, often with coalition partners.
3. Expected result: The comment becomes part of the administrative record. Agencies are not obligated to adopt the recommendations, but they must consider substantive comments, and organized responses can shape final language.

Common sticking point: Comment periods are fixed and short. Organizations that want to influence a rule have to track proposed rules continuously rather than react after the deadline.

Responding to and Pushing Legislation

NAC's legislative advocacy is visible in its public statements on bills moving through Congress. Two examples from its published posts:

• Older Americans Act reauthorization: NAC applauded the Senate's passage of S.2120, the Older Americans Act Reauthorization, on the law's 61st anniversary, and publicly urged the House to finish the process. The organization also published a policy brief titled The Older Americans Act: Supporting Family Caregivers to explain what the law does for caregivers.
• Appropriations and funding: After the Senate passed a Continuing Resolution, NAC issued a statement welcoming the secured funding while arguing that more is needed for family caregivers — a position that pairs acknowledgment of a legislative outcome with a specific ask for the next round.

What to take from this pattern: NAC rarely stops at "support" or "oppose." Its statements typically name the bill or resolution, state what passed, and then state what still needs to happen. That structure is what makes a statement usable by decision-makers and by caregivers who want to echo the ask.

Building and Working Through Coalitions

NAC does not advocate alone. The Caregiver Nation Coalition is the clearest example in its published activity: the coalition co-signed the response to the CY 2027 Medicare Physician Fee Schedule proposed rule, and NAC references the coalition as a vehicle for collective positions.

Coalitions matter for a practical reason. A single organization's comment carries some weight; a coalition representing many caregiver-serving groups carries more, and it reduces the risk that agencies dismiss a position as one group's preference.

If you are evaluating whether to join or follow a coalition's work, check:

Translating Research into Policy Arguments

NAC's advocacy rests on its own data. Its published resources include the Caregiving in the US Data Hub and Caregiving in the US 2025: Caring Across States & State Data Profiles, alongside reports such as Trends in Innovation: Implementing and Refining Caregiving Training Services in Medicare.

The function of these products in advocacy is to give policymakers a number and a geography. A state-level data profile lets a legislator see how many caregivers live in their state; a Medicare training report gives an agency evidence about how a service is actually being delivered. Without that, caregiver needs tend to be described only anecdotally.

NAC also frames its mission explicitly this way: translating "the lived experience of family caregivers into policy, system, and culture change." The Portraits of Caregiving section — profiles of individual caregivers such as Abena, Maggie, Myra, and Allen — serves the same purpose by attaching a person to the statistic.

How to Follow or Participate

If your goal is to track or support this advocacy rather than just understand it:

• Watch the news and blog feed on caregiving.org, where statements on rules and legislation are posted as they happen.
• Register for NAC webinars when the topic matches your interest — recent sessions have covered the cancer-to-transplant caregiving continuum, the dementia diagnosis gap and the ASAP Act, and results from the INCITE caregiver training program.
• Submit a comment yourself during an open federal comment period. NAC's filed comments are a usable template for the structure and the specific provisions worth addressing.
• Subscribe to the newsletter to receive policy updates without checking the site manually.

One caveat worth stating plainly: NAC's published material describes its positions and activities, not the outcome of every ask. A statement applauding a Senate vote is evidence that a bill passed, not evidence that caregiver funding was fully secured — which is exactly why NAC's own statements often pair the win with the remaining gap.