In a speech delivered to Congress Wednesday, President Joe Biden again mentioned the importance of providing care to seniors in their own homes.
Specifically, he touted his administration’s previously announced American Jobs Plan, which would include $400 billion for home-based care. Much of that money would go to the workforce, with home health and home care agencies fighting to recruit and retain workers as the demand for services rises.
“The American Jobs Plan will help millions of people get back to their jobs and their careers,” Biden said.
As the U.S. population becomes older, lots of caregivers are going to be needed. Right now, even without considering the onslaught of individuals entering their senior years in the next decade, providers are already struggling with staffing.
Traditionally, there has not been a great political focus on caregivers in the U.S., Abraham Brody, an associate professor of nursing and medicine at NYU Rory Meyers College of Nursing, told Home Health Care News.
“That is an issue that is costing both our economy billions of dollars annually in lost productivity and output, and has made it harder for women — in particular — to fully participate in the workforce in a lot of cases,” Brody said. “The opportunity both to address this from an equity lens, which has been a big focus within this administration, as well as to address something that affects economic output … it fills a huge hole in our social safety net.”
Around 1.3 million individuals will be needed in the direct care workforce by this decade’s end. But 6.2 million additional workers will also need to fill the empty slots made up by those who leave during that time, according to a recent report from the direct care advocacy organization PHI.
Well over half of those positions will be home care jobs.
“Two million women have dropped out of the workforce during this pandemic, too often because they couldn’t get the care they need for their family, their children,” Biden said. “800,000 families are on a Medicaid waiting list right now to get home care for their aging parent or loved one with a disability. This plan will help these families and create jobs for our caregivers with better wages and better benefits.”
Medicaid waiting lists are a significant crack in the U.S. health care system. They can be long and are extremely common, as the majority of states have significant wait times.
That’s part of the reason why the Biden administration wants to expand Medicaid under the Affordable Care Act (ACA). Some red states are reluctant to do so, however.
The administration recently rescinded a Medicaid waiver granted to Texas before it took over, a move that many believe is tied to the state’s resistance to expansion.
Sen. John Cornyn (R-Texas) is now making it harder for Chiquita Brooks-LaSure — the nominee picked to lead the Centers for Medicare & Medicaid Services (CMS) — to be confirmed due to the dispute.
“If you think [this issue] is not important, check out in your own district, Democrat or Republican,” Biden continued. “Their great concern, almost as much as the children, is taking care of an elderly loved one who can’t be left alone. Medicaid contemplated it, but this plan is going to help those families and create jobs for our caregivers with better wages and better benefits, continuing a cycle of growth.”
The American Jobs Plan also will vie for the expansion of the Money Follows the Person (MFP) program. That allows Medicaid beneficiaries to transition more smoothly from a nursing home back into their own homes.
As recently as September, the Trump administration directed a $165 million bump to the program.
“The opportunity to address this aligns with complete changes that have been performed in regulatory spaces to allow for the blossoming of home-based care,” Brody said. “For instance, the hospital-at-home program and MFP program are big changes that have occurred over the last couple of years. Coupling those things together — support for caregivers with more home-based care — that will allow older adults to stay in their environment without having to be institutionalized.”
Biden also introduced the American Families Plan on Wednesday, which he says addresses “the four biggest challenges facing American families today.”
Those four are access to good education, access to affordable child care, a lack of paid family and medical leave and a general lack of funds.
To address those, there are a slew of solutions provided, mostly paid for by hiked taxes on corporate entities and wealthy Americans.
“The American Families Plan will finally provide up to 12 weeks of paid family and medical leave,” Biden said. “No one should have to choose between a job and paycheck or taking care of themselves and a loved one – a parent, spouse, or child.”
That may cause home-based care providers to grow leery; paid leave time was a major staffing burden on them during the COVID-19 crisis.
But at the same time, child care could keep caregivers at work who otherwise may need to take care of their kids at home.
“It will provide access to quality, affordable child care,” Biden said. “We guarantee that low- to middle-income families will pay no more than 7% of their income for high-quality care for children up to the age of 5. The most hard-pressed working families won’t have to spend a dime.”
Biden also suggested he would work to keep premiums lowered during the pandemic at the same price and also expressed desire to lower deductibles.
“The pandemic has demonstrated how badly this is needed,” Biden said. “Let’s lower deductibles for working families on the ACA, and let’s lower prescription drug costs. We all know how outrageously expensive they are. … Let’s give Medicare the power to save hundreds of billions of dollars by negotiating lower prices for prescription drugs. That won’t just help people on Medicare – it will lower prescription drug costs for everyone.”
Biden additionally reminded Americans and Congress that his administration has overseen the delivery of 220 million COVID-19 vaccination shots since taking office — more than double their original goal.
He also recommended that The National Institutes of Health (NIH) create a research agency to lead studies that would result in breakthroughs for things like Alzheimer’s, diabetes and cancer.