Lee will leave her eastern North Carolina home next Tuesday and head to D.C. to take part in a Service Employees International Union (SEIU) day of action. The SEIU-backed rallies and marches in cities across the United States, including New York, Los Angeles and Chicago, are aimed at keeping pressure on Congress to include the $400 billion investment in Medicaid home health care President Biden proposed in his American Jobs Plan in upcoming budget reconciliation legislation. The money would increase both the number of caretaking jobs and the pay workers get for performing them. “Care can’t wait,” SEIU head Mary Kay Henry told me.
But will it need to? It’s no secret that many in the Democratic Party’s activist base are increasingly worried that it, like other long-cherished goals that Biden promised to deliver on — such as a public option for health-care coverage and bringing down the age of Medicare eligibility — will get pushed aside, done in by a combination of Republican intransigence and centrist hand-wringing about the size of the federal deficit.
Make no mistake, $400 billion is a lot of money, and the deficit is a serious and long-term issue. But it’s also true that the deficit often comes up as a major legislative roadblock only when it comes to the daily needs of average Americans. (Republicans sure weren’t all that concerned about it when it came to the Trump tax cuts for the wealthiest Americans — which they claimed, despite all evidence, would eventually pay for themselves). It could be argued, in fact, that the United States can’t afford to not begin making investments in human infrastructure such as elder care.
SEIU points out that increasing the number of home health-care workers available and paying them more money is both a jobs program and economic stimulus plan for this largely female and minority workforce — something that will not drain the economy, but improve it. “If we could make this poverty-wage job a good living-wage job, it will transform not just the caregiver’s life, but her family’s and her community’s and the entire neighborhood,” Henry said.
The United States, moreover, is a rapidly aging society, and one where affordable help — heck, sometimes any help — dealing with aging family members is in short supply, even as demand for it grows by the day. There are hundreds of thousands of elderly or disabled people who have qualified for in-home care paid for via Medicaid but are on waiting lists that can stretch for years, because state and federal funding hasn’t kept up with the demand. At the same time, turnover is high in the paid caretaker workforce, due to the combination of low salaries and long hours of hard physical and emotional labor.
The need to take care of elderly family members hits women particularly hard, upping their chances of leaving the workforce entirely. It’s an issue, as Henry notes, “that affects every family in every Zip code, blue states and red states.”
The lack of an adequate social safety net in the United States costs all of us — in time, in money, in emotional worry and energy. True, it doesn’t meet the traditional definition of infrastructure, but that doesn’t mean it’s not desperately needed. Just because the federal government doesn’t offer adequate help doesn’t mean the need goes away. Instead, the costs migrate to each of us individually, at one time or the other. We’re still paying the bill, in the form of low or reduced earnings, higher expenses or both — paying it out of pocket, one by one by one.