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This radical proposal would fund caregiving throughout a person’s whole life

Inside the push for Universal Family Care, an effort to help people pay for early childhood care, paid family leave, and long-term support for seniors as part of one comprehensive policy.

This radical proposal would fund caregiving throughout a person’s whole life
[Photo: Westend61/Getty Images]

Sarita Gupta describes herself as a member of the “sandwich generation.” On top of her career—she recently joined the Ford Foundation as the director of Future of Work(ers) after serving as co-executive director for two labor rights nonprofits, Jobs with Justice and Caring Across Generations—she takes care of her two aging parents and a young daughter. Throughout her career, Gupta has built up a long track record of advocating for the rights and fair treatment of marginalized workers, particularly caregivers. And she’s also among the more than 43 million Americans who provide unpaid care to others.

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What she’s heard from many others in that cohort, caught between a paying job and the need to care for a loved one, “is a feeling of being trapped,” Gupta says. “The cost of care is so unaffordable to many,” she adds. Nearly 70% of U.S. workers earn less than $50,000 per year, yet childcare can cost around $9,000 per year, and comprehensive eldercare can add up to even more (in-home care can cost as much as $50,000 per year). Medicare and many other forms of insurance don’t cover this long-term care. Confronted with these brutal economics, many people simply opt to leave the labor force and do the caring work themselves, rather than foot the massive bills. As a result, for the first time in years, the U.S. is seeing women’s labor force participation decline. And this is just the start of the trend: Around 10,000 baby boomers turn 65 every day and are living longer than ever. And at the same time, millennials are having children at a rate of nearly 4 million babies per year. The sandwich generation is about to get a lot larger, and a lot more sandwiched.

“All of this led us to say, This is one of the most pressing issues of our time. It will result in economic insecurity for so many families, and we need to really develop a robust care infrastructure,” she says.

[Image: U.S. Department of Labor/National Academy of Social Insurance]

Through Caring Across Generations, which advocates for protections and rights for caregivers, Gupta and her colleagues have created a proposal for Universal Family Care, a comprehensive program that would cover care needs across a person’s life. UFC would integrate three common approaches to providing care that are normally addressed in silos: early childcare and education, paid family and medical leave, and long-term services and supports for the end of life. A paper released in conjunction with the National Academy of Social Insurance, a nonprofit dedicated to analyzing social assistance policies and programs, presents various ways of implementing all three aims.

UFC would create a comprehensive “care insurance fund” that every American would both contribute to and benefit from. While this approach could work nationally, Gupta says Caring Across Generations feels that creating state-level funds might be more viable, especially in the short term. States like Washington, California, and Rhode Island have already created programs addressing elements of UFC, like long-term care support and paid family and medical leave.

To make it work, states could create a new fund paid for via a payroll contribution, similar to Medicare and Social Security, that would be administered to pay out to cover care expenses across the spectrum of life. At the moment Caring Across Generations is not making specific recommendations for funding and administering UFC, and instead presenting a range of ways in which the program could be designed. But the broad-strokes requirements of UFC are that every employed person would contribute a set amount from their paycheck toward a fund that they could then withdraw from at any point for childcare or other caretaking needs. States could decide to pull in additional funding for the program through an additional tax, which could be designed progressively so people with higher earnings contribute more to support those with fewer means. The intent of UFC is to make accessing the funding easier and more flexible by having the resources for a variety of needs—from early education to end-of-life support—available in the same place.

Rather than having separate programs for early childhood care and end-of-life support, Gupta says, a policy like UFC would create a backbone of continuous support. It’s designed to alleviate the strain that families often feel when forced to come up with funds for an unexpected need or crisis (which Gupta says can often total around $8,000 per year) and instead provide a readily accessible funding pool for families to draw on. It also acknowledges that often, care needs overlap—families like Gupta’s have to manage both long-term support costs and childcare at once, and UFC would alleviate the need to jump back and forth between different programs to access support. “It should be a simple program that covers a wide range of care needs,” Gupta says.

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Now the Caring Across Generations has drafted the report spelling out the case for UFC, it’s working to raise awareness around the UFC proposal and encourage states to design policies to enact it. Caring Across Generations has ties with legislators who have introduced elements of UFC, like paid family leave, and is consulting with lawmakers and advocates across the country about what approaches could work well for different states. To supplement that work, Caring Across Generations will be working with the Urban Institute to model different ways states could develop programs based around individual payroll contributions, but with enough flexibility to ensure that low-income people are given adequate financial support, even if their contributions to the fund are proportionately lower. Gupta says a critical factor will be ensuring equity in how UFC is implemented, as costs of care are the same for everyone across the income spectrum. It’s critical, she adds, for UFC to be able to close access gaps created by different levels of wealth.

There’s great potential, Gupta says, for a program like UFC to also enable the development of a strong and well-compensated care industry. Right now in the U.S., many professional caregivers are often underpaid, and people who leave the work force to care for family are often not paid at all. To support the demographic shift, “we really have to have a direct care workforce in place to support families,” Gupta says. “We believe that Universal Family Care would give us an opportunity to invest in care infrastructure now that will have great payoffs later.” Ideally, the program would ensure that care workers are paid fairly, which would open up opportunities for people to pursue caregiving as a viable career, which in turn would enable people working in other careers to remain in the labor force when confronted with caregiving needs.

A program like UFC that recognizes the growing need for support and caregiving across a person’s life, Gupta says, would not only help families maintain financial stability in the face of needs, but could also create a whole new and necessary industry for the U.S.

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About the author

Eillie Anzilotti is an assistant editor for Fast Company's Ideas section, covering sustainability, social good, and alternative economies. Previously, she wrote for CityLab.

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