Politics of Poverty

Biden makes bold move to support caregivers and care workers

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As he signed the Executive Order to support caregivers and care workers, President Biden was flanked by activists from a variety of organizations. Courtesy live stream of event

On April 18, President Biden signed an Executive Order that includes more than 50 directives to nearly every cabinet-level agency to expand access to affordable, high-quality care, and provide support for care workers and family caregivers. We chatted with Rebecca Rewald to get her reaction to the news.

MARY BABIC: Rebecca, thanks for sharing your expertise with us on this important issue. In his remarks at the White House, President Biden characterized it as “fundamental to who we are as a nation.”

My first reaction is, honestly, respect for the comprehensive and intelligent approach here. The team is really considering the issue of “care” in a wholistic sense, and looking for genuine solutions to deep-seated problems in the economy. And the audience seemed to reflect this, featuring people and organizations who’ve been on the forefront of this for decades.

First off, what is your reaction to this announcement?

REBECCA REWALD: I completely agree with you! This EO is a big deal!

It really shows that the Biden administration is doing what it can to support caregivers and care workers. Initially, President Biden worked with Congress on the American Rescue Plan Act—which included lots of care-related provisions—then the Build Back Better Act, which would have been the most historic investment in our care infrastructure ever.

Now that Congressional movement on care policies has waned, he and his team seem to be doing whatever they can without the legislative branch to address the care crisis. He did this by requiring any company that receives federal funds through the CHIPS Act to provide affordable child care for their employees, and by releasing a Presidential Budget Request this year that includes funds for paid leave, child care, and an expanded child tax credit.

So, this EO is part of a broader effort by the administration to do what it can to prioritize care, and you’re right, this EO is comprehensive. I particularly like that it focuses on both child care and long-term care, and that it aims to support unpaid caregivers and underpaid care workers; and it’s thinking up creative strategies.

For example, the Biden administration alone can’t pass legislation to strengthen the rights of domestic workers, but what they can do, and what they have done with this EO, is have the Department of Labor develop a sample employment agreement that domestic workers and their employers can use that better protect their rights.

MARY BABIC: Okay, let’s examine the framing from the White House, which sums up this EO as “actions to help families access care, support care workers and family caregivers, and strengthen the economy.”
Let’s take it step by step:

1. Help families access care

If families need to pay for services to help, it’s become astronomically expensive. Child care can run up to $17,000 a year (or more), often the largest item in a household budget. Elder care has gone up 40% in the last decade.

So many families can’t afford these expenses, often meaning that someone has to stay home and provide this care, unpaid, sometimes indefinitely. How does this impact women, in particular?

REBECCA REWALD: Caregiving is still considered to be “women’s work.” Even in the US, even in 2023, and even when women earn more than their husbands, this is still the case.

In many families, it’s almost always the women who has to stay home when child care becomes too expensive or unavailable. Dropping out of the workforce means women’s careers are stalled, they have less financial security, and are able to save less money in the long term, like for retirement. Women’s caregiving responsibilities is considered one of the reasons there is still a gender pay gap in the USwhile motherhood reduces women’s earnings, fatherhood can actually increase men’s earnings.

When looking at elder care, it is again usually women who are expected to care for aging relatives, often alongside care responsibilities they have for their own children; they are part of the “Sandwich Generation,” caught between young kids and older parents who are dependent on them.

Women make up 64% of the Sandwich Generation. These women often feel overextended, which can impact their mental and emotional wellbeing. Caregiving for aging relatives also causes financial strain—for women, the estimated amount of lost wages due to leaving the labor force early for caregiving responsibilities is $142,693 compared to $89,107 for men.

2. Support care workers and family caregivers

MARY BABIC: First, care workers are among the lowest-paid workers in the US, despite how fundamental their work is to keeping the economy going. Surely this reflects how our economy doesn’t value care work, casting it as unskilled—when we know well how difficult and demanding it is. The sector is overwhelmingly female, and disproportionately women of color. If we raise these wages, how will that affect these workers, and this sector?

REBECCA REWALD: Exactly, racism and sexism are why care work is undervalued and care workers are paid so poorly, which further entrenches gender and racial inequality in the US. Right now, too many care workers live in poverty because of poor wages. Raising the wages of care workers will mean more financial security for these millions of workers, further reducing economic, gender, and racial inequality.

It also means that care workers will be less likely to leave the sector. We’ve seen a mass exodus of child care workers and home health aides because of poor pay during the pandemic, and this means that child care and home care becomes even more unavailable for families. So, good wages for care workers are a critical part of making care services more affordable and accessible for families, and the Biden administration seems to get that.

MARY BABIC: Second, at least 53 million Americans serve as family caregivers (one in five adults). One has to assume most of these are women. How did COVID expose how the burden on women is so much heavier? How do we shift the narrative so this work becomes valued, rather than disregarded? Does Oxfam have a long-term perspective on this?

REBECCA REWALD: The care crisis and how it disproportionately affects women has been true for decades, but the COVID-19 pandemic really put a spotlight on society’s expectations on women’s responsibilities. We saw that with how many women dropped out of the workforce during the pandemic as schools and child care centers closed down, and how much slower women’s labor participation recovery has been.

I think the narrative shift has already started to happen with messages we’re seeing on social media from advocacy groups and political leaders. You see slogans like “care can’t wait” or “care work makes all other work possible” or “care is essential” all over the internet, and I do think repeating narratives like this will start to change perspectives.

It’s also critical that men become champions of care policies. While sexism means that the caregiving responsibilities disproportionately fall on women, that doesn’t mean that men don’t benefit from care policies, nor that men shouldn’t be allies to women in this fight. We’ve seen this with the creation of the Congressional Dads Caucus in the House of Representatives, with clear priorities around paid leave, child care, and the child tax credit.

Oxfam partnered with other organizations to run an ad campaign in April 2022 that included images of men and women trade workers holding up their babies and toddlers, with messages around how child care is part of our infrastructure. We specifically wanted to include a man in the campaign and tell his story, because we wanted to show that men ALSO benefit from access to affordable child care (even if it is women who reap the most benefits).

I also deeply believe that policy change leads to narrative change. If we value caregiving with our policies, that will signal to America that caregiving is important and that care work is crucial. For example, if we have federal paid parental leave for both parents, that will signal to Americans that spending time with their newborns is important for ALL parents, not just women. If we increase wages for care workers, we’re indicating that this work—caring for children, the elderly, and people with disabilities—is important, and that care jobs are good jobs.

Also, the way our policies are designed is WHY men are less likely to engage in caregiving. Closing the gender wage gap, better pay for care jobs, more paid leave—all of these policies will help shift norms around caregiving.

3. Strengthen the economy

MARY BABIC: What are some of the economic arguments for supporting care work?

REBECCA REWALD: It’s important to start off by saying that care work in it of itself is valuable. It’s a basic part of the way we live our lives and connect with our families and friends. All of us likely provide care for others and depend on care to survive.

But yes, care work also has huge benefits to our economy—it’s what allows people to go to work and earn a living.

In the US alone, it’s estimated that the amount of unpaid care work women amounts to about $1.5 trillion annually—this is more than double the US defense budget in 2019! In 2022, the US economy lost $122 billion because of an insufficient child care system.

For those who say they are concerned about our economy, this argument alone should convince leaders to make child care more affordable and accessible!

And finally, policies that facilitate our ability to provide care can lead to more productivity: companies that provide paid leave benefits are more likely to have satisfied employees and higher profitability. And some of the points I mentioned earlier—like how higher wages for care workers lead to less turnover and more financial independence—are all economic arguments for why care work should be prioritized.

MARY BABIC: Finally, good for President Biden. At a time when Congress is locked up by rancorous partisan divides, he’s looking for ways to implement change that supports working families. His proposed budget for 2024 includes investments in care, but it’s unclear what will make it through to the final version. Do you have thoughts about what he could do next, or what’s most important for Congress to take on?

REBECCA REWALD: I really think it’s now time for Congress to act on care. Our legislative branch is the one that can fundamentally transform the ways in which care work is supported and valued, and it’s Congress’s responsibility to respond to the needs of the citizens who voted them into office; and legislation to support care work is popular!

People want more affordable and accessible child care and paid leave is a popular issue for voters across the political spectrum!

Our commitment to care as a way to address inequality on lines of gender, class, and race

The reality is that “care” writ large has a wildly disproportionate impact on people already facing barriers: low-wage working families—especially women—unable to afford paid care, and care workers (mostly women and disproportionately people of color) paid low wages.

Oxfam is working alongside other organizations in advocating for solutions: legislation to make child care and long-term care more affordable and accessible; pay care workers better wages and strengthen their labor protections; pass paid sick leave and paid family and medical leave; and expand access to the child tax credit.

The good news is that legislation to do all these things exist! Here are some of these bills that Oxfam has endorsed:

  • Family and Medical Insurance Leave Act (FAMILY Act)
  • Healthy Families Act
  • Building an Economy for Families Act
  • Child Care for Working Families Act
  • Child Care for Every Community Act
  • Better Care Better Jobs Act
  • Home and Community Based Services
  • Domestic Workers Bill of Rights

For information on what is in the Executive Order, visit this fact sheet.

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