Understanding the Long-Term Care Crisis
Today’s care system deepens existing inequalities in the United States.
The demand for care is continuing to rise, and the cost of supporting care impacts budgets at every level – familial, state, and federal.
The care crisis disproportionately burdens low-income individuals, immigrants, women, and people of color.
Chart Source: PHI Quality Care Through Quality Jobs. 2023. Direct Care Workers in the United States: Key Facts 2023. https://www.phinational.org/resource/direct-care-workers-in-the-united-states-key-facts-2023/
For many, long-term care is unaffordable.
The long-term care (LTC) crisis is compounded by major wealth inequality, the economic and public health effects of the COVID-19 pandemic, and the housing crisis.
The average monthly costs for LTC range from about $5,000 for home care services and residential care to over $10,000 for nursing home care.
Yet, the average household only has around $9,000 in savings, and more than half of Americans 18 to 64 have nothing saved for retirement.
Households who don’t initially qualify for Medicaid LTC coverage often exhaust their savings and income to pay for care.
Chart Source: Genworth. 2022. Cost of Care Survey. https://www.genworth.com/aging-and-you/finances/cost-of-care.html/
Discrimination has brought us to the tipping point.
Our existing LTC system stems from a legacy of undervaluing the (paid and unpaid) care work of women, especially women of color. Our lack of care investment reflects a long history of marginalizing older adults and people with disabilities.
Today’s Care Workforce
Women of color make up the majority of today’s care workforce. These jobs have poverty-level wages, limited benefits, and high rates of occupational injuries, with few opportunities for career advancement.
All of this has led to high rates of turnover and growing workforce shortages. The heaviest burden of caregiving then often falls to family caregivers, thus limiting their own earning potential.
People with Disabilities
Younger people with disabilities are also burdened by care costs and income and asset restrictions of Medicaid, limiting their ability to work and grow wealth.
By expanding care access to all–and empowering care workers through a new working model–we can create a more equitable, accessible, and affordable system that benefits everyone.
Loss of Generational Wealth
Older adults often spend down their life savings to get the help they need through Medicaid. This limits the opportunity for generational wealth (the primary contributor to wealth in the U.S.).