An estimated 1 in 5 American adults provides care for another adult with physical or mental health needs, often with little formal support from the government. Covid-19 made caring for people vulnerable to complications more complex, while eroding the other sources of support that informal caregivers relied on in the past. Vox’s Katherine Harmon Courage takes a look at how our nation has failed to care for informal caregivers, and at policy solutions that could support those supporting their loved ones.
This unpaid work, which includes everything from trips to the doctor to feeding, bathing, and toileting, has been valued at $470 billion per year, equivalent to three-quarters of the entire budget of Medicaid. Even in the best of times, the vast majority of this work is invisible and undersupported, leaving millions of caregivers struggling in silence. … Before Covid-19, the US was lagging behind other countries in its support for informal, home-based care. Catching up would be a first step toward helping caregivers recover — for example, through tax credits, an expansion of federal family leave policies, and direct pay to informal caregivers. The Credit for Caring Act, introduced in Congress this spring, would give eligible family caregivers up to $5,000 per year to help pay for care costs. The Biden administration has proposed up to 12 weeks of annual paid family leave that would cover caregivers like the ones in this story, through the American Families Plan. But other plans have already fallen by the wayside.
Black women leading the fight against evictions
U.S. Rep. Cori Bush experienced the trauma and disruption of three evictions before winning a seat in Congress. That’s one reason why, when her colleagues headed back to their districts as the CDC’s eviction moratorium expired, Bush stayed in Washington, camping out on the Capitol steps in a move credited with galvanizing support for a new halt to evictions and pushing the Biden administration to act. Even before the pandemic, Black women and other women of color were far more likely to face eviction than their white peers. Now, as Dr. Nadia E. Brown writes in The Grio, Black women are leading the fight against pandemic evictions, and to reduce the burden that evictions force on the evicted.
Black women — like Reps. Cori Bush, Maxine Waters, and Ayanna Pressley — are fighting back against evictions. The Louisiana Fair Housing Action Center (LaFHAC) is working to create a support network for Black women in both New Orleans and Louisiana to find housing options. The Black women that LaFHAC seeks to help are precisely those in need — those that have past evictions and/or criminal records — which makes renting more difficult as many landlords do not want to rent to these individuals. The organization, which is led by Cashauna Hill, is lobbying the Louisiana state government to enact policies that will help women with past histories of eviction or criminal records secure housing.
The racism at the heart of American welfare policy
The Temporary Assistance for Needy Families program (TANF), which replaced the nation’s cash welfare program in 1996, took substantial government support away from poor families, while doing little to nothing to meaningfully help poor families meet their needs without that aid. While the changes enacted in the welfare “reforms” of the mid-1990s hurt poor families regardless of their race, the changes were driven by racist assumptions about welfare receipt and subjected Black women and children to particular harm. Now, a tiny and shrinking proportion of Louisiana’s poorest families – 4 in 100 families with children living in poverty – are served by the state’s cash assistance program, the lowest figure in the nation. A new report from the Center on Budget and Policy Priorities lays out the connections between racist policies dating back to the time of enslavement and the welfare policy we live with today.
Federal policymakers created TANF in 1996 with the purported promise of helping families lift themselves out of poverty through work. But much of the debate around the 1996 law was centered (often implicitly, but sometimes explicitly) on Black mothers, who were portrayed as needing a “stick” to compel them to be more responsible and leave the program. TANF’s harsh work requirements and arbitrary time limits disproportionally cut off Black and other families of color. Also, Black children are more likely than white children to live in states where benefits are the lowest and where the program reaches the fewest families in poverty. In the decade after policymakers remade the cash assistance system, it became much less effective at protecting children from deep poverty — that is, at lifting their incomes above half of the poverty line — and children’s deep poverty rose, particularly among Black and Latinx children.
U.S. dead last, again, in measure of health care performance
The United States spends more on health care than any other wealthy nation, and gets the least in return for its spending. A new report by the Commonwealth Fund quantifies just how bad our nation’s bargain is: Compared to other high-income countries, America ranks last in access to care, administrative efficiency, equity and health care outcomes, coming out ahead only in “care process,” a measure that accounts for preventive care, safe care, coordinated care and engagement and patient preferences. The report charts a way forward for American health policy:
Four features distinguish top performing countries from the United States: 1) they provide for universal coverage and remove cost barriers; 2) they invest in primary care systems to ensure that high-value services are equitably available in all communities to all people; 3) they reduce administrative burdens that divert time, efforts, and spending from health improvement efforts; and 4) they invest in social services, especially for children and working-age adults.
Number of the Day
$470 billion – Estimated economic value of the care that unpaid people provided to loved ones with mental or physical health needs in America in 2017. (Source: AARP Public Policy Institute)