"This is about easing the squeeze on working families who are raising their kids and caring for aging loved ones at the same time," says Biden. "Sometimes separately, but many times together. It's about creating jobs with better pay and career pathways for caregivers and showing them that dignity and respect that they deserve."
Part one of the "Build Back Better" plan focused on expanding manufacturing in the United States; part two detailed his plans to address climate; and part three is centered around creating affordable child care options for working parents and increasing access to long-term care for the elderly and disabled communities.
With a price tag of $775 billion over 10 years, Biden's parent and caregiver plan will be funded by rolling back tax breaks for real estate investors with incomes over $400,000 and increasing tax compliance for high-income earners. The plan is centered. It will create 3 million new jobs while also increasing pay.
"Families are squeezed emotionally and financially. They need help. Too often they can't afford it," says Biden. "And the professional caregivers out there, the home health care workers, childcare workers are more often women, women of color and immigrants are too often underpaid, unseen, and undervalued. The pandemic hits and squeezes and tightens on everybody. "
Joe Biden's parent and caregiver plan, explained
1. Expand access to child care
Under Biden's proposed plan, every three- and four-year-old child will get access to "free high-quality preschool," he says. "And lower-middle-income families won't spend more than 7 percent of their income on child care for children under the age of five, the most hard-pressed working families won't have to spend a dime."
Biden outlined two potential pathways for families. The first option would allow families to get up to an $8,000 tax credit for childcare. "For a middle-class family with a couple of young kids spending 300 bucks a week in childcare, that means an annual savings of $8,000 in their pocket," he says. The other option would allow parents to apply through the state to federal funds that cover the costs of childcare that are more than 7 percent of their household income. The state reimburses the childcare center on the back end. "You just pay what you are supposed to pay," he says. "Not a dime for some working families, but no more than 7 percent for anyone else. You can do that. This will save families thousands of dollars."
2. Expand access to long-term care for the elderly and disabled
There are millions of informal family caregivers around the country, and they're often unpaid and unsupported. Biden's plan would make long-term care for the elderly and disabled more accessible.
"The last few months have only underscored how vital it is for families and older Americans to have more homecare and community care choices that fit their real needs," says Biden. "We're trapped in a caregiving crisis within an economic crisis within a healthcare crisis."
There are currently 800,000 people who are eligible for Home and Community Care through Medicaid, Biden explains, but they're waiting for a phone call to connect them to this care. "For some the wait is five years—five years," he says. "My plan makes a bold investment so states can clear the waiting list to make sure we ease the financial burden for more families going forward. We have to make long-term federal investments."
Biden also plans to make home security care more widespread. Just about $3,000 in program costs yields more than $20,000 in savings to the government in payments for things like hospital visits, he says.
"For example, there's a pilot program now in 27 cities in 16 states where a nurse, an occupational therapist, and a handyman come to the home that's caring for an aging family. They might not be able to cure mom's Alzheimer's, but they make sure she doesn't break her hip," says Biden. "They install handrails in the right spots in the house in the bathroom, or they fix the door, the stuck door, so she doesn't trip while she tries to open it."
3. Recruit and train new health professionals
Biden's plan aims to create 150,000 new jobs in community health care.
"Whether you live in rural North Carolina or central Philadelphia, people of color or economically distressed communities face punishing health disparities from a system of systemic discrimination," says Biden. "They don't have health insurance. They don't see a doctor. Sometimes language is a barrier. They slip through the cracks—slip through the gaps—so their treatable condition, because they can't afford to go to the doctor, becomes a chronic condition. That's why community health workers are real heroes. They go to these communities, they make sure folks are getting the care they need."
4. Increase pay for workers in early-childhood and long-term care
"We need to pay and support caregivers beyond what they are now," says Biden. "They're doing God's work, but home health workers aren't paid much. They have few benefits, 40 percent are still on SNAP or Medicaid. So my plan is direct. It gives caregivers and early childhood educators a much-needed raise. No one should have to work more than one job to make ends meet."
Biden's parent and caregiver plan includes expansions to the Affordable Care Act that would provide more affordable health insurance options to workers in early-childhood and long-term care. He says he'll also ensure that these workers have an effective way to unionize and collectively bargain and protect their rights and earn benefits. Additionally, he wants to make training and continued-education opportunities accessible.
"For example, a home health care worker can have access to training needed to become an EMT or a nurse or physician's assistant, or even a doctor," he says. "Or the early childhood educator can receive coaching to keep delivering a high-quality learning experience."
5. Allow family caregivers to go back to work
Many parents have to stay home with their children instead of working because childcare is so expensive. Biden wants to make it so families have more of a choice in this matter, and that women, primarily, are able to work when they want to. Affordable child care paired with up to 12 weeks of paid family and medical leave could do that.
"We can free up millions more people to join the paid labor force, increasing economic growth," says Biden. "Today millions of our people can't fully pursue the jobs and careers they dream of due to the caregiving squeeze. That means, tens of billions of dollars less in wages each year for our working families. It means more disruption for our businesses, fewer jobs, and growth in our economy slowed. This is both a moral and an economic imperative for the nation"
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