Millions of Americans care for aging parents or partners. That number will rise.
Vice President and Democratic presidential candidate Kamala Harris garnered headlines recently when she announced her proposal to cover home health care workers under Medicare. This is smart politics. Supporting elder care would address a critical need and is broadly popular. Harris is well-positioned to advocate for this cause.
The growing caregiving burden on American families
Caregiving is a pressing issue. Millions of Americans care for aging parents or partners, and their work is intensifying. According to the National Alliance for Caregiving and AARP, over 20% of Americans are caregivers for an adult or a child with special needs. The number of caregivers has grown by around 10 million, compared to 2015 data. What’s more, the U.S. Centers for Disease Control reports that pressures on family caregivers will likely grow in coming years. Demographic trends suggest an increase in those who will need care will coincide with a decrease in the number of family caregivers available to provide care.
A sizable number of folks are already “sandwiched” between responsibilities to kids and parents. Roughly one-quarter of Americans have elderly parents and are also parents with kids younger than 18. For 40 to 49-year-olds, this percentage jumps to 54%.
The costs to families are tremendous. Assisted living facilities cost almost twice as much as the median income of a Medicare beneficiary; a full-time health aide costs almost 8 times as much. Analysis by health policy organization KFF indicates that more than half of those who paid for family care needed to cut spending on clothing, food, or other essentials to afford it.
So how has the government responded to the growing caregiving burden?
Harris’ plan is not the first attempt to address the needs of caregivers in recent years. President Biden and congressional Democrats championed a number of ambitious caregiving policy changes in 2021, including increased compensation for home care and workers, and expanded long-term care access for seniors and persons with disabilities. Republican lawmakers, however, universally opposed these plans, which ultimately were defeated.
But the Harris proposal is novel. Her plan uses Medicare to provide coverage of home caregiving – help with daily living such as eating and bathing. Currently, Medicare recipients are only eligible for limited types of specialized care. And funding through Medicaid is very low, and subject to variation in state support. Harris’ plan would also extend Medicare coverage to hearing and vision benefits, and prohibit state seizure of family homes to recoup care costs.
A campaign pledge doesn’t ensure policy change, of course. The Harris campaign has laid out a broad plan to fund the program chiefly through savings accrued in drug negotiations – but many details still need to be articulated. And most of the plan relies on Congressional support, which is only likely if Democrats win majorities in the House and the Senate. But there is good reason to believe that this plan will serve Harris well on the campaign trail, and that she would be motivated to deliver on it if elected to office.
Our research finds bipartisan public support for caregiving policies
Policy proposals to support caregivers tend to be popular, even in times marked by profound partisan polarization. We surveyed a nationally representative group of 1,029 Americans in July 2021. Democrats in our survey overwhelmingly support a range of investments in caregiving – and independents are generally supportive as well. While Republicans opposed some proposals and supported others – notable percentages of Republicans support a range of caregiving policies. In other words, while Democrats are more uniform in their support, there is bipartisan interest among the public for investment in care.
Support for elder care has received less media coverage than childcare. But support for elder care is particularly popular across party lines. According to our survey, 73% of all respondents indicate that the government should provide families with aid for eldercare costs; this includes 90% of Democrats and 59% of Republicans. A majority of respondents, 64%, also support an increase in the wages of homecare workers. Democrats are much more likely to support this policy than Republicans (80% of Democrats versus 42% of Republicans), but the level of Republican support is nevertheless striking.
Why Harris is a compelling champion for elder care policy
Harris may be a particularly effective messenger on this policy. Voters tend to trust female candidates and Democratic candidates more on issues linked to care. And women are more likely to prioritize these policies once in office. Even before this proposal, Harris’ focus on the “care economy” generated enthusiasm among caregiving advocates.
In the coming years America will need robust policy solutions to address the challenges of caregivers and those they care for. In the coming weeks we will see if voters view Harris as the right woman for the job.
Jill S. Greenlee the Max Richter Associate Professor of Politics and Women’s, Gender & Sexuality Studies at Brandeis University. She is the author of “The Political Consequences of Motherhood” (University of Michigan Press, 2014).
Jennifer Merolla is professor of political science at the University of California, Riverside.
Rachel VanSickle-Ward is a professor of political studies at Pitzer College, where she specializes in public policy and gender and politics. She is the co-author of “The Politics of the Pill: Gender, Framing and Policymaking in the Battle over Birth Control” (Oxford University Press, 2019).
Ivy AM Cargile is an associate professor of political science at California State University, Bakersfield.
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