A pair of leading caregiver advocacy groups this week released a report outlining a roadmap for Universal Family Care, a social insurance plan that would cover family care across the life span, including infant care, child care and elder care.
The report, by the Caring Across Generations and the National Academy of Social Insurance, aims to inform policymakers of the need to dramatically overhaul an infrastructure for care that was built around a traditional one-income family that largely no longer exists.
“We all struggle to juggle work and care,” said Benjamin Veghte, research director at Caring Across Generations. “But we inherited a caregiving infrastructure from 50 years ago.”
The current system is inefficient, he said. People now pay for care only when they need it or when crisis strikes, a system that heavily taxes new parents who are early in their careers and lacking savings, or older adults needing care later in life when they rely on fixed incomes.
An alternative would be for people to pay steadily in smaller amounts via a payroll tax throughout their working years or a tax on investment income, he said.
Current social insurance programs, such as Medicaid, only cover long-term care needs for the poorest Americans. The vast majority of families pay out-of-pocket for care — at a price tag of approximately $50,000 a year for someone who is elderly or disabled or about $10,000 a year for child care, the report said. The high cost means that many people quit or lose their jobs to provide care, jeopardizing their longer term financial security.
Caregiving demands are expected to intensify as the number of seniors needing long-term care is projected to rise from 6.3 million in 2015 to about 15 million by 2050, according to the report.
The federal government passed the Family and Medical Leave Act in 1993, but the law only allows for unpaid leave. Since then, six states and the District of Columbia have passed laws that provide paid family and medical leave. In 2017 Hawaii passed the nation’s first family caregiver benefit. And in May, Washington state approved the nation’s first state-based long-term care social insurance program which would provide families up to $100 a day for care needs for 365 days.
The 300-page report and a corresponding op-ed in the New York Times were released as the presidential campaign is heating up in advance of the 2020 election.
Ai-jen Poo, co-director of the Caring Across Generations, said at an event at the National Press Club Monday that policy discussions throughout much of recent history have remained on the margins, focusing on small fixes and limited dollars — debates that often pit social solutions against each other.
But since the 2016 election, she said she has seen an appetite grow for “big ideas,” such as the current debates around Medicare for All, or the Silicon Valley-seeded idea about a universal basic income.
Universal Family Care is a similar a big idea, she said, and one she believes will be propelled by women, who are overwhelmingly the ones who play the roles of both paid and unpaid caregivers.
“Now with women driving change in every aspect of our culture and politics — from marching to leading the #metoo movement to voting, running and winning elected office in unprecedented numbers — the space for change and appetite for bold ideas – especially ideas with women at the center — continues to open.”
Meera Dahiya contributed to this report.
Michael Alison Chandler is managing editor at MemoryWell. Previously, she was a staff writer at the Washington Post for 13 years.