As we head into the final days of one of the closest, most contentious presidential elections in memory, both campaigns have made it clear that the votes of women, especially working mothers, will be a key to winning the race. But while President Barack Obama and his Republican challenger, former Gov. Mitt Romney of Massachusetts, have slung arrows at each other on issues ranging from job creation to the deficit to foreign policy, neither has taken much opportunity to address a critical issue facing the middle-aged women who can make or break the election: family caregiving.
We have 65 million caregivers in this country — 1 in 3 households has one — and 66 percent of those caregivers are women, who spend on average 20 hours a week caring for an older or ill loved one, or for sons or daughters wounded in military service. Approximately 24 million Americans are living in the Sandwich Generation, simultaneously caring for young children and an aging parent. And 7 out of 10 caregivers juggle these family responsibilities along with full- or part-time jobs. Yet the candidates have not included clear caregiving positions in their policy statements.
This shortcoming is surprising because caregiving is not invisible to these men — both have experienced it in their personal lives. Obama helped care for his aging grandparents, who had helped raise him, and for his mother, whom he lost to ovarian and uterine cancer. First Lady Michelle Obama grew up with a father who struggled with multiple sclerosis. Mitt Romney's wife, Ann, has lived with MS since 1998. Romney also helped care for her when she faced treatment for breast cancer four years ago. The Republican vice presidential candidate, Rep. Paul Ryan of Wisconsin, has also spoken about his experiences with his grandmother, who had Alzheimer's disease, and moved in with his family while he was in high school.
Where the Candidates Stand
I asked both campaigns for statements on family caregiving. The Obama campaign responded to my request with the statement below. The Romney campaign did not send a statement. We have, however, the candidate's record as governor to draw on, as well as comments he made on the campaign trail and at the debates.
Several legislative milestones related to caregiving have been ushered in since the president took office in 2009:
- The National Plan to Address Alzheimer's Disease. In May, the president authorized $100 million in the fiscal year 2013 budget to support the National Plan to Address Alzheimer’s Disease, which was signed into law in 2011. The plan sets forth five goals, including caregiver support and the development, by 2025, of effective prevention and treatment approaches for Alzheimer’s and related dementias.
- The Caregivers and Veterans Omnibus Health Services Act of 2010. The act calls for caregiver support programs to be administered by the Department of Veterans Affairs, including a toll-free national caregiver support line, local caregiver support coordinators in each VA medical center and better respite care benefits and stipends for veterans' caregivers.
- The White House Middle Class Task Force Report 2010. This report called for a $102.5 million Caregiver Initiative to support programs that provide caregivers temporary respite care, counseling, training, referrals to critical services, transportation help, adult day care and in-home services, like aides to help seniors bathe and cook. Such help eases the burden for family members and helps seniors stay in their homes.
The president has shown support for policies benefiting the nation’s caregivers, but has rarely addressed their challenges or needs in his campaign speeches. However, the campaign did share this statement with me:
The Romney-Ryan approach, on the other hand, would take us backwards. They have pledged to block grant Medicaid and slash its funding, which would undoubtedly force states to cut back on the home and community based services on which family caregivers rely. And the Ryan budget calls for steep cuts in domestic discretionary spending — so it could cut programs that support family caregiving by 19 percent if applied evenly across the board. Our family caregivers can’t afford these drastic plans.
Romney established a legislative record on caregiving and veteran support during his single term as governor from 2003-2007. (He did not seek re-election.) On the campaign trail, he has addressed issues of concern to working women which could impact their roles as caregivers.
- Special Commission on Long-Term Care for Persons with Adult Onset Disabilities (S.B. 2582). As governor, Romney signed into law this bill establishing a new commission charged with investigating long-term care options for underserved adults between the ages of 19 and 59 who are neurologically or physically disabled, including those with Parkinson’s disease, spinal cord injuries and MS. The commission was charged with reporting on the adequacy of various services for this population and on the respite care needs for disabled adults cared for by family members or friends in the community.
- The Welcome Home Bill. In 2005, Romney's Welcome Home Bill was passed by the Massachusetts Legislature. It increased benefits for Massachusetts National Guard members and provided them with reduced life-insurance premiums and free tuition and fees at Massachusetts universities and community colleges. A year later, he signed into law the Massachusetts Military Enhanced Relief Individual Tax Plan, which provided tax exemptions to disabled veterans and benefits to the families of fallen and missing soldiers.
- Endorsement of flex time. In response to a question during the second debate about how he'd support women in the workplace, Romney did not directly address caregiving, but he did endorse flex time to aid working mothers, a policy often cited as a crucial need for caregivers on the job as well. A 2012 Society of Human Resources Management report found that 77 percent of employers offer some form of this benefit to their workers, up from 66 percent in 2005.
- Recognition of women living in poverty. In a campaign appearance in Virginia, Romney was quoted by CBS News as saying that Obama "has failed America's women, they've suffered in terms of getting jobs, they've suffered in terms of falling into poverty." During the second debate, he stated that 26 million American women were "trapped" in poverty today, the highest rate in 17 years. We know from multiple studies that about half of all women who reach age 65 will live to 85 or beyond, but 92 percent of these older women do not have sufficient retirement plans to finance those years. So they often turn to family members, most often their daughters, to provide caregiving or cover their care costs. A National Alliance for Caregiving study found that 47 percent of caregivers use their own retirement savings to support a loved one, potentially creating a future population of impoverished caregivers.
The Voters' Choice
In broad strokes, Obama is an advocate for financing federal programs to support families and caregivers, while Romney would give more control of that financing to the states. Many of the most innovative caregiving programs and services are developed at the state or county level, but such programs, like California's Caregiver Resource Centers, often find themselves in jeopardy as governors and legislatures struggle to balance their budgets. The elimination of such crucial support programs only makes caregivers more vulnerable when it comes to their own health and wealth. And as the candidates debate cuts in the federal budget that could affect caregivers, it's useful to keep in mind that, as a recent article on the campaign from the British newspaper The Guardian pointed out, "cuts in programs aimed to help families may reduce public debt but increase private debt."
Caregiving advocates like me encourage caregivers to speak up and let the candidates and other policymakers hear your voice in support of the programs that are so critical to long-term care in this country, 80 percent of which is provided by a family member. Perhaps we need a Caregiving Party to bring more attention to these issues, as happened in Australia when the Carers Alliance Party was launched. But the best way to use your voice right now is to use your vote. Care enough to head to the polls on Nov. 6.