As the nation’s population ages, the need for more care workers and safer, more affordable care options is urgent.
By 2050, the number of individuals in need of long-term care services will likely double from 13 million in 2000 to over 27 million people.
To address the growing demand, President Biden has earmarked $400 billion of his $2 trillion jobs plan to expand access to quality, affordable home or community-based care for aging and disabled Americans.
“Even before COVID-19, our country was in the midst of a caregiving crisis,” notes a Biden administration fact sheet on the plan. “These investments will help hundreds of thousands of Americans finally obtain the long-term services and support they need, while creating new jobs and offering caregiving workers a long-overdue raise, stronger benefits, and an opportunity to organize or join a union and collectively bargain.”
Specifically, President Biden’s plan would expand access to long-term, home-based care services under Medicaid, in addition to providing a $5,000 tax credit for family caregivers.
This will allow millions of people who need care to stay in their homes and avoid unnecessary placements in nursing homes — over 70 percent of which are for-profit and owned by private investors.
New analysis from the National Bureau of Economic Research found that between 2004 and 2016, private equity ownership of nursing homes increased the mortality rate of residents by 10 percent compared to those living in homes with other ownership structures, suggesting that more than 20,000 people died as a consequence of living in nursing homes run by private equity firms during this period.
The COVID-19 pandemic exacerbated the risks of the for-profit model for vulnerable nursing home residents and employees.
A study published in the Journal of the American Medical Association found that throughout the pandemic, for-profit nursing homes had lower supplies of personal protective equipment for their workers when compared to other types of nursing homes.
In New Jersey, the state with the highest nursing home death rates during the pandemic, for-profit nursing homes had infection rates 24.5 percent higher than the statewide nursing home average and death rates more than 10.2 percent higher.
The Biden plan will also improve care options by improving the working conditions for home care workers, who currently earn on average just under $17,000 a year. One in six live below the poverty line. Among all U.S. home care workers, over 90 percent are women, more than half are women of color, and 31 percent are immigrants.
The Biden administration’s infrastructure plan would finally cement long overdue protections for this essential workforce, including awarding care workers the ability to raise wages and gain stronger benefits through collective bargaining.
When working conditions improve for the nation’s caregivers, we all benefit. A UMass Boston study found that increasing wages for direct care workers will greatly enhance workers’ financial security, improve productivity, and increase the quality of care. A similar study found that increased pay for care workers prevented deaths, reduced the number of health violations, and lowered the cost of preventative care.
These necessary measures are a step forward in undoing unjust racial and gender discrimination in the workforce, while also solidifying a strong care economy for the future.
“This will have a great impact in our lives and for the next generation of caregivers to come,” said a California-based Filipina home care worker who identified herself as Teresita in a Twitter video. “It allows us to support our families and give us the dignity and respect that will inspire us to work hard to deliver quality care.”
Rebekah Entralgo is the managing editor of Inequality.org at the Institute for Policy Studies.