Universal Family Care: Behind the Latest 'For All' Designed to Rethink Aging
WHY YOU SHOULD CARE
Because universal family care could be the next universal basic income.
By Carly Stern
On winter nights, young Josie Kalipeni could be found assembling puzzles of the Wonders of the World. Kalipeni always had a knack for seeing the bigger picture. With it, she brings an aptitude for finding and connecting disparate parts to make those visions real.
Today, the 38-year-old Malawian immigrant is piecing together an ambitious American ideal that’s not yet entered the policy mainstream: universal family care.
Kalipeni is director of policy and federal affairs for Caring Across Generations, a national campaign reimagining the long-term care system that’s an offshoot of the National Domestic Workers Alliance and Jobs With Justice. Universal care accounts would function like a multipurpose Social Security insurance fund: One pays directly into it over a lifetime — ideally, in Kalipeni’s mind, with the government matching contributions — and could draw from it to pay for child care, take time off work to care for ill parents or pay a home health care worker to support a relative with disabilities.
[Caregivers] don’t want to have to choose between a paycheck and caring for a loved one.
Universal family care is designed to address pain points of a “sandwich generation” under ballooning pressure: those caring for an aging parent, raising their children and working full time. The care burden weighs heavier on working women of color in the U.S., who’ve been caregivers by cultural tradition and through the infrastructure of slavery, while facing an acute wage gap and less intergenerational wealth. But it’s a problem that touches all demographics: An estimated 41 million people gave 34 billion hours of unpaid care to adult loved ones in 2017, spending roughly $7,000 on caregiving costs like transportation and home modifications, according to recent AARP research. “Family caregivers make it very clear that they don’t want to have to choose between a paycheck and caring for a loved one,” says Kalipeni. But they must navigate a fragmented safety net of programs, like parental leave or medical leave, depending on what their state or employer offers.
Paid family and medical leave are generating bipartisan support, while proposals deemed more radical — like Universal Basic Income or Medicare for All — have oxygen on the Democratic campaign trail. In her role, Kalipeni writes draft bills for Congress and state legislatures — Hawaii and Washington have already implemented programs — while cultivating allies for the cause. It’s a steep climb, but Kalipeni is invigorated by the question she’s chosen to chase: How would we design long-term care if we were starting from scratch?
Her answers are shaped by life experience. Kalipeni’s family came to America when she was 8, settling in Illinois. Josie was a natural caretaker as the oldest of six, says her mother, Fattima Kalipeni, who has worked as a domestic worker and nurse. (Kalipeni’s father worked in academia.) Both parents put in long hours and Josie was accustomed to pulling people together, Fattima says. Her favorite book was about a boy in Malawi who built a car out of scrap metal, and she begged for puzzles at garage sales — she always wanted to be a connector.
“Holding the wealth of America [and] … at the same time holding the deep poverty of Malawi caused and causes a constant rustle in me,” Kalipeni says. She watched as relatives in both countries faced similar challenges to sustain their families, find employment and create dignified lives. The University of Illinois graduate wasted no time getting into rooms where she could unpack these questions: Kalipeni supported hard-to-adopt youth in the foster care system during her first internship, organized for an Illinois health care campaign and worked for the D.C.-based advocacy organization, Families USA. After the Affordable Care Act’s Medicaid expansion started to roll out across the country, she sought the next burgeoning care issue.
And she watches her work spill over into her own future. Fattima cares for Kalipeni’s father in his declining health, but when she fell ill, the six siblings scrambled to patch together a care schedule. And ever since a surgery left Kalipeni bedridden for three months, she has worried about who will care for her as she ages, as a single woman without children.
She isn’t alone in these worries. Family caregivers must sacrifice their jobs, their time or both — trade-offs that people universally experience but are socialized to internalize on their own with shame, says Wendy Chun-Hoon, executive director of the advocacy organization Family Values @ Work. “The reality is that this is a systemic failure, not a personal failure,” Chun-Hoon says. “And we can solve for this.”
It’s easy to envision a political constituency given high voter turnout among women of color and baby boomers, but a large new government benefit would face opposition from Republicans — and has not gotten attention amid the fierce debate over Medicare for All in the Democratic presidential primary. The states offer possible test cases, but logistical questions linger. Hawaii gives family caregivers working at least 30 hours a week outside the home up to $70 per day in benefits through revenue in the state’s general fund. A payroll tax funds Washington’s Long-Term Care Trust Act, which will provide a lifetime benefit of $36,500 adjusted for inflation. Minnesota, Illinois and Michigan are exploring different public and private plans, while a group in California might pursue a ballot initiative.
“We’re having the conversations in Congress now to really socialize this idea,” says Kalipeni. “Something that would have taken 20 years to have credibility … has a much more truncated [timeline].”
And she thinks her charge suits this dynamic political moment: “People are excited about big ideas.”
OZY’s 5 Questions With Josie Kalipeni
- What’s the last book you read? Talking to Strangers by Malcolm Gladwell.
- What do you worry about? Whether this is the world I want to bring kids into and whether I’ll be in a position to provide my parents all the opportunities and choices they provided me with.
- What’s the one thing you can’t live without? Crunchy Flamin’ Hot Cheetos.
- Who’s your hero? Outside of my mom, my sister Melissa. She’s a warrior, open to being herself and vulnerable.
- What’s one item on your bucket list? To visit every African country.