The U.S. Must Do More to Care for Its Caregivers
Older Americans receive generous benefits, but the immigrants who support them receive little from the government.
About the authors: Catherine S. Ramírez is professor of Latin American and Latino studies at the University of California at Santa Cruz. Her book Assimilation: An Alternative History was recently published by the University of California Press. Glenn Kramon is a lecturer at the Stanford Graduate School of Business.
Some of the couples eligible for coronavirus-relief stimulus checks last year, and who could receive up to $2,800 more under Joe Biden’s proposed plan, paraded in their golf carts in support of Donald Trump through the Villages, a Florida community for people over 55. Many are retired and living comfortably, their benefits protected by the government safety net. If they had lost jobs during the pandemic, they would have been eligible for expanded unemployment benefits.
Many of the home-health aides and nursing assistants, some of them elderly themselves, who care for retirees in places like the Villages do not enjoy the same benefits. In Florida, more than 40 percent of these workers are immigrants, both authorized and unauthorized. This percentage does not include the groundskeepers, maintenance people, housekeepers, and food workers who keep retirement communities and nursing homes running. A growing number of all of these workers are now struggling, turning to food lines around the country.
According to a Pew Research poll, many Americans in the Silent Generation believe the myth that immigrants burden, rather than strengthen, the United States, when, in fact, the opposite is true. Our aging population depends on immigrants, not just for elder care but for health care (immigrants are playing a huge role in caring for COVID-19 patients), technological innovation (think Zoom, created by a Chinese immigrant), agriculture, and other aspects of a dynamic economy.
The Biden administration must work to narrow the gap between what older Americans and the immigrants who support them receive from the government. And older Americans, including the two of us, must acknowledge our country’s dependence on immigrants and contribute more to earn our keep.
For four years, Trump instituted policies that rewarded retirees. In response to his 2020 budget proposal, for example, the Urban Institute reported, “By proposing to pare down discretionary programs even further than under current law, abandon the Affordable Care Act, and cut back on Medicaid (all while still retaining large deficits), [Trump] demarcates the elderly as the only spending priority for new resources other than foreign and domestic bond holders.”
While Trump favored the elderly, he sought to exclude those who help them the most. The CARES Act, passed last spring, distributed $1,200 cash grants to tens of millions of Americans. However, it did not include many immigrants, including undocumented workers as well as U.S. citizens and legal permanent residents who were related to undocumented immigrants, even if they worked at essential jobs. Although those in mixed-status families received $600 checks as part of the new stimulus program in December, the government still ignored the undocumented workers who help to keep society afloat.
The Trump administration also restricted the number of people who could come into the country, despite a growing shortage of workers who care for the elderly and the disabled. Trump’s wealth test for prospective legal permanent residents dismantled family reunification, a cornerstone of U.S. immigration policy since 1965. He overturned U.S. asylum law and shut out refugees and foreign workers, including H-1B and Diversity Visa holders.
Biden is taking many steps to right these wrongs. In his platform, he recognizes immigration as “the reason we have constantly been able to renew ourselves” and as “essential to who we are as a nation, our core values, and our aspirations for our future.” Biden has taken up immigration as one of the first issues to tackle in office, offering a path to citizenship for those in the country without legal status.
The Biden plan for elder care, child care, and caregivers would dedicate $775 billion over 10 years to working parents caring for elderly parents, small children, and family members with disabilities. It also promises more jobs and higher pay for professional caregivers. However, Biden should go further. He should follow the lead of Representative Joaquin Castro of Texas and Senator Alex Padilla of California in calling for a fast track to citizenship for undocumented essential workers.
Heeding this call would allow the U.S. to join other democratic nations, including Italy and France, in recognizing a dependence on immigrant workers. Italy offered undocumented domestic-care and agricultural workers temporary amnesty in 2020, a move that some decried as too restrictive. France expedited citizenship for immigrant essential workers, from doctors to garbage collectors.
The pandemic has given new urgency to the question of what we owe each other as citizens. The coronavirus doesn’t distinguish citizens from noncitizens and authorized immigrants from unauthorized ones. As California’s Governor Gavin Newsom declared when he unveiled the Disaster Relief Assistance for Immigrants plan last April, “We are all in this together.” The program ended on June 30, and the $125 million in cash assistance for undocumented immigrants was only a small fraction of what’s needed. Still, it was a step in the right direction.
However, many people don’t define “we” the way Newsom does. They believe the stereotype that immigrants siphon jobs and entitlements from people born in the U.S. This is simply not true. Not only do documented and undocumented immigrants fill jobs that most Americans don’t want, many pay taxes and contribute to Social Security.
Retirees, on the other hand, take far more in government and private benefits—including Medicare, Social Security, and pensions—than their parents or grandparents did. Entitlement programs benefiting the elderly compose close to half of the federal budget, up from about a quarter 50 years ago. That’s more than $30,000 annually for each elderly American, according to the Urban Institute.
Older Americans believe that they worked hard, paid into the system for decades, and deserve their entitlements. But, in fact, a Baby Boomer couple retiring at 65 last year, with one partner having earned an average wage and one a low wage, will have paid about $120,000 in Medicare taxes and will receive benefits worth about $500,000, according to Eugene Steuerle, a former Treasury official now at the Urban Institute. (Those figures are in present-value terms, adjusting for inflation and assuming a real rate of return of 2 percent.)
Some Americans note that the strain on our federal budget is not the growing cost of retirees but the low taxes for the extremely wealthy. We agree that these taxes should be much higher, to subsidize retirees and everyone else. But even if Jeff Bezos and all the other billionaires paid in 100 percent of their income, it still wouldn’t come close to covering the growing cost of the aging population.
The Biden platform promises to protect programs for the elderly and proposes additional ways to do so—breaks for long-term care and a tax credit for informal caregivers, for example. That’s admirable. But older Americans, in particular the healthy and more comfortable, need to contribute more. As we are vaccinated first and emerge from our homes more safely, we must continue to work, volunteer, and donate to causes that benefit the less fortunate and enrich society. The Biden plan promises to encourage older people to keep working, by fighting age discrimination and offering tax incentives. We must think more about being productive versus unproductive, about giving versus taking, and about acknowledging who helps keep our country running.