Although I applaud the passage of the Inflation Reduction Act, I’m frustrated that the provisions aimed at helping women — namely, to better support paid and unpaid caregivers — were left on the cutting room floor.
As I have written repeatedly, we are in the midst of a care crisis in our country. Labor Department data show that the share of women participating in the workforce has yet to rise to pre-pandemic levels, with mothers working less than other women. Most cite the lack of affordable child care or elder care as a reason for cutting back hours or dropping out of the workforce altogether.
The situation is even more acute for the professional caregiving workforce. Women account for an astounding 81% of all workers in the residential long-term care industry. According to the Bureau of Labor Statistics, the number of nursing home workers remains 11.5 percent below its level in February 2020.
The IRA does nothing to address those issues. Early promises in the Build Back Better Act to establish a universal and permanent paid family leave act, expand access to high-quality home care and extend child tax credits have vanished.
President Biden and Congress can’t just declare victory and move on. Our country’s inability to solve those issues deeply affect our productivity and economic security, not to mention our moral standing in the world. As Hubert Humphrey said, “The moral test of government is how that government treats those who are in the dawn of life, the children; those who are in the twilight of life, the elderly; and those who are in the shadows of life, the sick, the needy, and the handicapped.” In that regard, I’m afraid we’ve failed. Until we make caregiving issues as important to lawmakers as infrastructure and energy, we can act on three critical intermediary steps.
1. Increase public investment in the long-term services and supports system
The demand for long-term care is far outpacing the supply of workers, which means that older adults are forced to go without professional care options and families struggle to fill in the gaps.
According to the Service Employees International Union, more than 420,000 workers — almost 10% of the workforce — left the long-term care industry between the start of the pandemic and January. As a result, most long-term care facilities have had to turn people away, and more than 300 nursing homes have closed since the pandemic began. LeadingAge reports that three-fourths of staff say they are leaving for higher pay.
Some provisions to boost the careforce are included in the Labor/Health and Human Services appropriations bill, such as doubling the Department of Labor’s Closing the Skills Gap grant program, which is focused on expanding apprenticeship pathways for certified nursing assistants, licensed practical nurses, registered nurses and rehabilitation technicians.
2. Ensure healthcare coverage and paid family leave
Although efforts to improve career pathways are critical, they don’t address the primary needs of these workers: better pay and benefits.
The Inflation Reduction Act provides some health security by extending for three years the Affordable Care Act subsidies that enable low-income workers to purchase health insurance, but a federal paid family leave program must be enacted as soon as possible. The lack of universal paid family leave adversely affects our society’s health, progress towards equity, and workforce. African American and Latina caregivers are more likely to be working full time while balancing caregiving responsibilities. Because women provide two-thirds of unpaid care, they are more likely to experience workforce interruptions, leading to lost benefits and promotions at work.
3. VOTE and make caregiving issues a priority
Women’s issues must not be allowed to be pushed to the sidelines. With reproductive rights threatened across the country, women may be forced to have children without any help with childcare or other necessities.
Seventy percent of people turning 65 today will need long-term care before they die, yet our nation has no real plan in place to provide this care.
Women comprise more than half the population and have cast almost 10 million more votes than men in recent election. We must demand that caregiving needs are front and center for all elected officials.
Nora Super is the former senior director of the Milken Institute Center for the Future of Aging and executive director of the Milken Institute Alliance to Improve Dementia Care, positions she just recently departed. She continues to lead NS Ideas LLC, a boutique health and social policy consulting firm, in partnership with her husband, health economist Len Nichols.
The opinions expressed in each McKnight’s Senior Living guest column are those of the author and are not necessarily those of McKnight’s Senior Living.
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