In November 2025, Australia started big changes to aged care. The goal was to give older people respect, choices, and safe help. The new Aged Care Act 2024 and the Support at Home program promised to fix the problems identified in a 2021 report. But after three months, one thing has made many very upset: the new fees.
At the NGO Training Centre, we spend our days talking with aged care providers across the country. Lately, one topic keeps coming up again and again, and not quietly. The new home care co-payment arrangements have become the loudest, most emotional flashpoint in the broader aged care reforms.
And honestly, it is not hard to see why.
Under the new settings, everyone now contributes something toward the cost of their home care. How much they pay depends on income and assets, including the value of the home, with contributions reaching up to 50 per cent of service costs. On paper, this is about sustainability. In real life, it is about older people and families trying to make sense of bills they never expected to see.
We are hearing the same stories that providers are. A simple shower, help with meals, or domestic support suddenly feels expensive. Families are shocked when they see hourly rates climb into the hundreds. For people who sit just above concession thresholds, the system can feel like a trap rather than a safety net. As Queensland Greens Senator Penny Allman-Payne put it bluntly, “We are making it hard for parents to stay home.”
The anger has spilled everywhere. Senate hearings in December were tense, with senators grilling officials about complaints that appear to have gone nowhere. Stories surfaced of families paying $3,000 for minor gardening jobs, or $14,000 for safety rails, leaving little funding for actual health supports. In Queensland, assessment wait times are around 20 per cent longer than the national average. Some older people report skipping meals to save money. These are not abstract policy debates. They are daily realities.
Advocacy groups like COTA Australia warn that 20 to 30 per cent of people may withdraw from home care altogether because it has become unaffordable. As COTA’s Ian Yates said, rights look good on paper, but they mean very little if people cannot afford to exercise them. Media commentators have gone further, describing the shift as “money-first care for the old,” arguing that some for-profit providers are using the complexity of the new rules to overcharge for small jobs.
At the same time, there is another truth we cannot ignore. Australia’s population is ageing rapidly. There are now around 4.9 million people aged 65 or older, and that number is expected to reach 6 million by 2030. Without some form of shared contribution, many argue the system simply will not survive. Peak bodies representing providers point out that the workforce is already stretched thin, grappling with reform fatigue, compliance changes, and rising operational costs.
So here we are, caught between sustainability and fairness.
One story that stayed with us was shared by a 78-year-old woman interviewed by the ABC. Her fees tripled. She now showers only twice a week to keep costs down. “I worked for 40 years to relax,” she said, “not to choose between clean and broke.” Calls to My Aged Care have reportedly jumped by 40 per cent, driven by confusion and frustration. Officials describe these issues as “start-up problems,” but for the people living through them, they do not feel temporary.
From our perspective, this is where providers sit in an incredibly difficult position. You are the face of a system you did not design, explaining rules you did not write, to clients who are scared, angry, or both. The reputational risk is real, even when pricing reflects genuine costs. So is the moral distress felt by staff who entered aged care to help, not to argue about invoices.
As we head toward the May 2026 budget, pressure is mounting for adjustments. Some are calling for an additional $5 to $10 billion in funding to soften co-payments. Others suggest that technology fixes, such as faster digital assessments, could reduce delays and frustration. Those conversations matter, and they will continue.
But right now, the dominant mood is not optimism. It is raw frustration.
This is why we believe training has never been more critical. Not just clinical skills, but communication, ethical decision-making, trauma-informed care, and navigating difficult conversations about cost and choice. Providers need support to help their workforce explain the system with empathy, recognise when financial stress is affecting wellbeing, and advocate appropriately within the boundaries they operate in.
These reforms were meant to support Australians in their later years with dignity. At the moment, many feel they are being tested by fire instead. Our role as a training organisation is to stand alongside providers as you navigate this space, build confidence in your teams, and keep the focus where it belongs: on people, not just policy.
The debate about co-payments will continue. In the meantime, the way we support older Australians through it will matter more than ever.
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Author: Cathy Kerr BANurs, GDAET, Cert IV Training and Assessment.
Cathy brings over three decades of expertise to the field of nursing education, with a distinguished career as a registered nurse, educator, and now aged care consultant. Her extensive experience spans clinical practice, training, and consultancy, where she has dedicated herself to improving care standards and supporting both ageing individuals and healthcare professionals. With a deep understanding of the sector’s challenges and opportunities, Cathy combines her nursing background with a passion for education to drive positive outcomes in aged care.
