Roads, Waterways and ... Home Health Aides?
There's a reason Joe Biden put this in his economic agenda. And it's a good one.
President Joe Biden's economic agenda goes well beyond traditional infrastructure projects. And the piece that will strike many as the weirdest fit is a downpayment on what's come to be known as the care economy.
It's the subject of my latest piece at HuffPost.
The proposal Biden outlined last week included a call for dramatically more support of "home- and community-based services" for seniors and people with disabilities. These are the supports for people who need some kind of assistance with daily living, in order to stay at home rather than in some kind of institutional setting.
Think a senior citizen who wants to stay out of a nursing home, or maybe somebody with a physical impairment trying to go to college. Chances are, you know somebody who falls into one of the categories -- and you might too, or will someday.
Current funding for these supports and services is limited, which is why an estimated 800,000 people are on state waiting lists, sometimes for years. Hundreds of thousands more don't even bother adding their names because it seems so futile. It's quite a difference from the support for nursing homes and other institutions, which is much more available, because it comes through Medicaid and that was the emphasis when the program came into existence 50 years ago.
Biden wants to fix that so that individual needs and desires, not a quirk of federal reimbursement policy, determines whether people go into congregant care settings or stay at home. It's a cause that advocates have championed for years, and that makes a ton of sense on the merits.
OK, you say. But what's it doing in the jobs plan?
This doesn't look like a traditional infrastructure project. It's not an investment in transportation or utilities -- and it's not a one-time expenditure that will end once the project is done.
But putting money into care can yield real economic benefits.
It can free up time for family caregivers who can and want to spend more time in the paid workforce (or pay them for their time at home, by the way). It can help the people who get these services to be productive. It can raise incomes and workplace standards for the chronically, depressingly underpaid caregiving workforce -- which helps them and also improves the quality of care, which has its own payoff.
That last part is huge, by the way, given that care workers represent one of the largest and fastest-growing parts of the labor force.
This kind of investment doesn't come cheap. For these home- and community-based services, Biden is proposing $400 billion in new spending. That's for the ten-year budget window, but it would likely turn into an ongoing commitment.
There's a lot of work to do on these proposals, both figuring out the legislative specifics and then building majority coalitions that can get them through Congress. But this is a big first step and one that deserves some attention.
Here’s a link to the article: https://www.huffpost.com/entry/joe-biden-caregiving-infrastructure_n_60689a5bc5b6c55118b3e942
And here’s one of the many reports out there, making an economic case for these sorts of investments: https://timesupfoundation.org/newsroom/times-up-report-a-bold-public-investment-in-caregiving-amidst-covid-19-crisis-will-create-jobs-and-build-our-economy/