'Game changer': Biden’s $2 trillion infrastructure plan makes a big bet on caregivers

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The word “infrastructure” tends to evoke images of bridges and roads, but President Biden’s proposed $2 trillion infrastructure plan is seeking to broaden that concept to include caregivers.

And unions helping those workers organize to make the case that they are “infrastructure” too. The economy’s foundation, advocates argue, has expanded well beyond asphalt and steel beams.

“It’s a change in the public perception of what we mean by ‘infrastructure,’” Mary Kay Henry, the Service Employees International Union’s international president, told Yahoo News.

Henry continued: “That home care and childcare workers are part of the nation’s infrastructure and deserve taxpayer investment just like rebuilding roads and bridges, restoring the electrical grid, dealing with the expansion of solar and wind. I think that’s an incredible indication of how COVID has shined a light on the essential work that’s done in the economy by workers who were invisible before, and became visible, because as we were ordered to stay at home, a whole part of our country kept going to work in order to make things move.”

The American Jobs Plan, which Democrats hope to pass through a narrowly divided Congress this year, assigns $400 billion for care for the elderly and those with disabilities through Medicaid. The funding would pay for the care of those individuals by visiting staff, allowing people to move out of long-term facilities and back into their homes. Biden promoted those aspects of his proposed legislation during a rollout speech Wednesday in Pittsburgh.

“It’s going to extend access to quality, affordable home or community-based care,” Biden said, while also touting the bill’s funding for roads, bridges and airports. “Think of expanded vital services like programs for seniors, or think of homecare workers going into homes of seniors and people with disabilities, cooking meals, helping them get around their homes, and helping them be able to live more independently.”

Maria Colville
Personal care assistant Maria Colville. (Lane Turner/Boston Globe via Getty Images)

Many of those jobs are performed by women of color, sometimes undocumented, and are frequently low-paying. Experts have warned about a coming care crisis for years, but former President Donald Trump’s immigration crackdown accelerated concerns. One study found the policies would compromise care for the elderly and disabled while services for in-home aides reported shortages in applicants. As part of his proposal, Biden is seeking to increase pay for those workers, although the details are being left to Congress.

Henry described the legislation as “the first jobs program that is focused on an industry that is primarily women of color.” She added: “These women turned out in record numbers for Joe Biden and Kamala Harris, and I think they’re going to see themselves in the jobs investment that he’s proposing.”

Biden echoed similar themes in his Pittsburgh speech.

“For too long, caregivers — who are disproportionately women, and women of color, and immigrants — have been unseen, underpaid and undervalued,” Biden said. “This plan, along with the American Families Plan, changes that with better wages, benefits and opportunities for millions of people who will be able to get to work in an economy that works for them.”

Biden’s choice of Pittsburgh as the venue for rolling out his plan highlighted the changing dynamics of work in much of the country.

The Rust Belt city has been cited by Republicans like Trump and Sen. Ted Cruz as an example of why the United States had to pull out of the Paris climate deal, leaning on the alliterative contrast despite Pittsburgh’s commitment to green energy and jobs. While it is sometimes stereotyped as an industrial town, over the last few decades the city has transitioned to a hub for health care, technology companies and higher education. However, much of the surrounding area has been overlooked.

Joe Biden
President Biden after speaking about infrastructure spending in Pittsburgh. (Evan Vucci/AP)

According to census tracking cited in University of Chicago historian Gabriel Winant’s book “The Next Shift,” which tracks the shift of jobs in Pittsburgh from the heyday of the steel industry to today’s care economy, one-in-seven jobs nationwide are in “health care and social assistance,” with the rate in some Northern and Midwestern cities where hospitals are primary employers rising to one in five. These positions accounted for 74 percent of low-wage job growth in the 2000s, up from 56 percent in the 1980s.

Winant writes: “Care workers are at once everywhere and nowhere. They are responsible for everyone, but no one is responsible for them,” resulting in a situation where “workers thus become collectively indispensable yet individually disposable.”

“It’s insulting to be called ‘essential’ and then be paid poverty wages and not get the [personal protective equipment] you need, and all these kinds of outrages we saw early on in the pandemic,” Winant told Yahoo News. “The main problem that any long-term care worker will tell you they experience on their job is understaffing, before they tell you about their wages. We just need way more people doing that work especially as the baby boomers retire and age.”

Winant said that the labor movement traditionally shifts with the cycle of economic change and development but that it also lags.

“This process of change is intrinsic to the history of the labor movement and it’s why the labor movement historically doesn’t grow incrementally,” Winant said. “It grows in huge spikes and declines over long periods of time, then grows in another huge spike as it figures out how to adapt itself to a new environment and innovate new organizational forms. All of that is to say I think we are due for another moment like that.”

In addition to the funding for care workers, Biden has requested funding to repair thousands of miles of roads in addition to thousands of bridges. There are also provisions for electric-vehicle chargers, electrifying 20 percent of the nation's school buses, airports, waterways and low- and middle-income housing. The White House has said it plans to follow the American Jobs Plan with a second proposal that would provide programs like free community college, universal prekindergarten and a national paid-leave program.

Lora Lodkina, left, and Galina Zhidkova
Home health aide Lora Lodkina, left, helps Galina Zhidkova with some shopping in the Brighton neighborhood of Boston. (Suzanne Kreiter/Boston Globe via Getty Images)

Biden’s policy plans face critics from both the left and the right.

Many conservatives, who already tend to oppose new domestic spending programs, argue that the concept of “infrastructure” can’t be as broad as Democrats and unions are pushing for. Republicans have criticized the bill for funding not only care workers, but the electrical grid, water systems and broadband.

“I was shocked by how much doesn’t go into infrastructure,” Gov. Kristi Noem R-S.D., told Fox News host Sean Hannity. “It goes into research and development. It goes into housing, and pipes, and different initiatives, green energy, and it really is not an honest conversation we’re having about what this proposal is.”

Senate Minority Leader Mitch McConnell said Thursday, “I’m going to fight them every step of the way, because I think this is the wrong prescription for America.”

Some progressives, meanwhile, argue that the bill doesn’t go far enough, and are pushing Biden to combine the two legislative packages out of fear the second one will be unable to pass.

“I want to see the details of how they’re planning to make sure that the climate issues and the childcare issues don’t get left behind,” said Sen. Elizabeth Warren, D-Mass. “We can’t have the train leave the station and critical parts are left on the platform.”

Rep. Pramila Jayapal, D-Wash., chair of the Congressional Progressive Caucus, similarly argued that “this package can and should be substantially larger in size and scope.”

“While we understand there is a separate package to be released on broader care economy supports, health care, and free college, our preference is for a single, ambitious package that would include both physical infrastructure and care infrastructure – these investments go hand-in-hand, and we need both to restore our economy and empower families,” Jayapal said in a statement.

Democrats can’t afford to lose the support of their own party’s lawmakers if they want to pass the massive spending legislation. Without any Republicans on board in the Senate, Democrats would have to use the process of reconciliation to pass the bill, meaning all 50 members of the caucus have to sign off on it. Opposition from any individual senator on the left — like Warren or Sen. Bernie Sanders, who has proposed including Medicare expansion in the package — or a small group of House Democrats would scuttle the bill’s chances the same as Sen. Joe Manchin, D-W.Va., one of the most outspoken moderate members.

While polling shows the proposal being broadly popular among the American people, that doesn’t mean it will necessarily garner any Republican support. Biden’s COVID-19 relief plan — which enjoyed over 70 percent approval in multiple polls — earned zero GOP votes when it passed last month. As he did with that bill, Biden is likely to make the case that “bipartisan” needs to be redefined.

Meanwhile, organizations like the SEIU say they will be mobilizing their workers to push for the bill, including working with climate activists to lobby legislators.

Henry said “this jobs program represents a sea change and makes caregiving a good job of the future that people could actually raise their families on rather than scrape to get by, and that’s going to be a big game changer.”

Winant said the legislation is a positive step, but that considerable work remains from both labor-friendly politicians and the workers themselves.

“Ultimately, you can’t remake the labor movement and you can’t rebalance society just from the White House or from Congress,” Winant added. “That’s an important part of it but workers’ collective self-assertion has always been a central part of that process, and there are huge obstacles to that at the moment in labor law and the structure of labor markets.”


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