Insurance does not cover home attendants even when medically necessary. Our benefits did pay for skilled nursing visits and home health aides for assistance with showering twice a week, but for the 24-hour care the doctor prescribed, we had to pay out of pocket. The summer after Brad came home, we spent more than $21,000 on in-home care, dipping into savings and an inheritance from my mother to do so. We were very fortunate to have those resources; for many families, it would be out of reach.
It’s often noted that the United States is alone among rich nations in not providing maternity leave; support for child care is likewise abysmal. Similarly — but often more invisibly — we leave millions of caregivers with little or no support in managing the financial, logistical and emotional difficulties of helping ailing parents, spouses and children.
The Biden-Harris campaign made an ambitious caregiving plan a key plank of its platform. Early signs from the new administration are promising. Mr. Biden’s $1.9 trillion coronavirus emergency relief package includes measures benefiting caregivers: extending stimulus payments to cover previously overlooked adult dependents, tax credits, and paid family and medical leave. Some of these benefits would help family caregivers of all kinds; others specifically aid those tending people with Covid-19.
Although pandemic relief is the most urgent priority, change must not stop there. The plan Mr. Biden rolled out during the campaign proposed an integrated approach to supporting child care, care for older people, paid care work, and family caregivers. Among other measures, it floated a $5,000 tax credit for unpaid caregivers, Social Security credits for those who must leave their jobs to provide care, and 12 weeks of guaranteed paid family leave.
The plan would also offer wider access to home- and community-based long-term care and support services. Gaps in Medicaid coverage for these services has resulted in long waiting lists and made it harder for people to receive needed care at home.
Such changes would clearly benefit both family caregivers and paid workers, who are disproportionately women of color. With few job protections, in-home workers have long had difficulty finding stable, well-paid work, a plight worsened by Covid-19. The Biden policy team has argued that its plan would create up to three million jobs in care work and education, benefiting populations hit hard by pandemic job losses.
The changes wouldn’t help just caregivers like me; what’s good for caregivers also benefits those who need assistance. Expanding home care can keep frail elderly people out of nursing homes, the drawbacks of which have been painfully exposed by the pandemic. Easing financial strains and burnout for caregivers can mean better, more compassionate treatment, which in turn can improve quality of life and outcomes for our most vulnerable citizens.