Heidi Hartmann & Jeff Hayes on the Home Care Workforce and the Future of Elder Care

Heidi Hartmann and Jeff Hayes, both based in Washington, DC and formerly at the Institute for Women’s Policy Research, discuss their study on the shifting supply and demand of care work. They found immigrant workers are increasingly essential to direct care, with a growing share of workers being people of color and about three-quarters women, while pay remains low and many workers rely on public benefits; under-the-table work is hard to measure. They describe a shift away from nursing homes toward aging at home, increasing demand for home care, more medicalized and monitored work, and concerns that immigration restrictions are worsening worker shortages and raising costs. They note Medicaid both supports patients’ home-based care and indirectly subsidizes low wages, and suggest policy changes such as more public funding (potentially via Medicare or Medicaid asset-limit changes) and special visas for home care. They close with advice for baby boomers to save, plan for non-financial caregiving needs, and maintain friendships and support networks.   Topics 00:00 Meet Heidi and Jeff 01:47 Care Work Study Findings 03:00 Who Does Care Work 03:43 Low Wages and Benefits Gaps 05:39 Medicaid and Under the Table Work 06:25 Post Pandemic Care Shift 10:45 Why Care Is So Expensive 13:14 Personal Elder Care Stories 19:47 Immigration Crunch Ahead 21:10 Policy Fixes for Long Term Care 23:43 Immigration Reform Ideas 26:19 Advice for Baby Boomers