Biden Announces $775B Plan to Boost the Caregiver Economy, Support In-Home Care Providers

Senior care — an increasingly important topic that’s too often overlooked on the campaign trail — is back in the spotlight.

And maybe this time it will have some staying power.

Presumptive Democratic presidential nominee Joe Biden has floated a sweeping new 10-year plan that seeks to dramatically change the way older adults are cared for in the United States. Specifically, the former vice president’s proposal calls for a $775 billion overhaul of the nation’s caregiving infrastructure, which is largely made up of women and people of color.

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Biden’s campaign announced he would discuss the “21st Century Caregiving and Education Workforce” plan Tuesday afternoon during a speech in New Castle, Delaware.

Policymakers and government officials have long undervalued and under-invested in older adults for decades, LeadingAge President and CEO Katie Smith Sloan told Home Health Care News in an email.

The COVID-19 pandemic has now exposed the devastating impact of that failure, she added.

“The vital role of family and paid caregivers has never been clearer, nor has the reality that our current system needs to be rebuilt to meet the needs of a rapidly growing older population,” Smith Sloan said. “Any candidate for president should be focused on this important issue – as we expect older adults and their loved ones will be this November.”

Washington, D.C.-based LeadingAge is a nonprofit trade organization that represents a variety of providers operating in the aging services field.

While few details were made available prior to the speech, the Biden campaign said the proposal would lead to 3 million new caregiving and education jobs during the next decade. Additionally, the plan seeks to create pathways for former caregivers to re-enter the workforce if they choose to do so.

Robert Espinoza, vice president of policy for New York-based advocacy organization PHI, also told HHCN that the plan appears to be a step in the right direction.

PHI advocates on behalf of home-based care workers and the individuals they serve.

“It’s encouraging to see Joe Biden prioritize caregiving issues on the national stage, including the importance of expanding home- and community-based services to more Americans,” Espinoza said. “However, to ensure access to home care and other caregiving supports, we must also transform the quality of direct care jobs, from higher compensation to improved training and career advancement opportunities, and much more.”

Nationwide, aging experts estimate that about 10,000 baby boomers turn 65 each day. In order to keep up with their demand for home care services and general preference for aging-in-place, the home care industry will likely need to fill at least 4.2 million more caregiver jobs by 2026.

But low wages generally make finding caregivers a difficult task. Roughly one in six U.S. caregivers currently lives in poverty, according to PHI data.

Besides supporting the “caregiver economy” in the senior care space, Biden’s proposal also looks to strengthen America’s child care system. Senior care and child care providers have both been hit hard by the coronavirus, which began spreading across the country in March.

Despite challenges related to sourcing personal protective equipment (PPE) and maintaining an adequate front-line workforce, home-based care organizations have played a key role in caring for older adults and other high-risk populations during the coronavirus emergency.

In his $775 billion plan, Biden seeks to use $450 billion to boost senior care. CNBC reported that some of those funds will be used to increase Medicaid funding to states, in part to eliminate the 800,000-person waiting list for community-based and in-home care.

Biden’s plan would also fund programs to create 150,000 new jobs for community health workers and invest in innovative new models of long-term care outside of traditional nursing homes.

Supporting Medicaid home-based care should be a focus of the upcoming presidential election, according to David Totaro, chairman of the Partnership for Medicaid Home-Based Care (PMHC).

Headquartered in D.C., PMHC is an advocacy association whose members include Medicaid home care providers, managed care companies and other senior care stakeholders.

“PMHC is pleased to see that Medicaid home-based care is a priority issue for the upcoming election,” Totaro told HHCN in an email. “Given the impact of COVID-19 on long-term care facilities, it is time for federal leadership to remove the institutional bias within the Medicaid program and recognize home- and community-based care as a cost-effective and consumer-preferred option for seniors and individuals with intellectual and developmental disabilities who wish to remain safe and healthy in their home.”

Another aspect of the plan: the establishment of a nationwide Public Health Jobs Corps.

The Administration for Community Living — part of the U.S. Department of Health and Human Services — floated such a concept in November of last year.

Apart from adding to the caregiver workforce, Biden has also signaled his intent to improve working conditions by backing the Domestic Workers Bill of Rights Act.

The home care industry has largely opposed such legislation, which would create additional administrative requirements like predictive scheduling.

In terms of funding Biden’s caregiving plan, his campaign noted it “will be paid for by rolling back unproductive and unequal tax breaks for real estate investors with incomes over $400,000 and taking steps to increase tax compliance for high-income earners,” The Wall Street Journal reported.

“These plans are really about easing the squeeze that working families all over this country are feeling every day,” a senior campaign official said Monday while briefing reporters on the Biden proposal. “Our country is experiencing a caregiving crisis.”

Biden isn’t the first presidential candidate to push for long-term care reform.

Last August, presidential hopeful Bernie Sanders (I-Vt.) tweeted that “no senior should have to sell their belongings or spend their life savings just to be able to age in place.”

Similarly, former presidential candidate Cory Booker, a senator from New Jersey, released a long-term care plan that included aging-in-place funding last July.

At the time, voicing support for aging in place and long-term care reform failed to bring either candidate newfound momentum. As the national conversation continues to revolve around the coronavirus, though, senior care could turn into a core campaign focus during the 2020 president election.

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