She can start by supporting the Fair Pay for Home Care Act and hitting the brakes on changes to the Consumer-Directed Personal Assistance Program.
Opinion Editorial in Albany Times Union, December 19, 2024
By Elise Nakhnikian, Bobbie Sackman and Michael Solow
As older adults, we want home care to be there when we need it. And as health care programs face new uncertainties under the incoming Trump administration, Gov. Kathy Hochul needs to prioritize New Yorkers’ well-being in her upcoming budget.
In New York, Medicaid pays for about half a million home care workers who assist hundreds of thousands of older adults and younger people with disabilities, and that number is growing fast. Many thousands more New Yorkers are waiting for the other shoe to drop — for that phone call saying that Mom or Dad had a medical emergency.
But Project 2025 outlines a plan to decimate Medicaid as we know it. And President-elect Donald Trump’s plans to cut taxes for the wealthy and slash the federal budget would balloon the federal deficit, making Medicaid even more vulnerable.
New York already has the worst home care worker shortage in the nation, largely because wages are so low that it’s a struggle for those who care for the rest of us to care for their own families. More than 40% of New York’s home care workers already live in or near poverty. What’s more, privatization in home care has led to massive profiteering, leading to worse outcomes for consumers.
So far, Hochul’s support of home care has been inconsistent at best. In 2023, she signed off on a $3-an-hour raise for home care workers, an important first step but far short of the bipartisan Fair Pay for Home Care Act, which would have created a living wage set at 150% of minimum wage.
Unfortunately, she has since backtracked. First, Hochul tried to roll back the $3 raise. She rebuffed an attempt to get rid of the private insurance companies that serve as costly middlemen in our Medicaid home care system, siphoning out an estimated $3 billion in profit every year. And her changes to the Consumer-Directed Personal Assistance Program, the trusted program through which more than half of our state’s Medicaid-funded home care recipients get assistance, could result in tens of thousands of older and disabled New Yorkers losing their home care.
As the governor assembles her next budget, Hochul has a chance to rethink her priorities and provide New Yorkers with the home care they need.
For a start, she could support Fair Pay for Home Care. A CUNY analysis showed that paying home care workers a living wage would not just help those who rely on and provide home care; it would also make our state’s economy stronger. Better paid workers would spend more at local stores, pay more taxes and stop needing SNAP and other public assistance. Hundreds of thousands of their children would be lifted out of poverty.
The governor could support the Home Care Savings and Reinvestment Act, which would get rid of middleman insurance companies, freeing up billions for care and wages rather than executive salaries and stock buybacks. Finally, Hochul could back legislation to rescind the move to a single private company to run the Consumer-Directed Personal Assistance Program.
This isn’t just humane policy and good economics. It’s smart politics. Most New Yorkers will give or receive home care at some point. Home care also allows millions of care recipients’ friends and relatives to do their own work without taking budget-crippling time off.
In this time of political uncertainty, we do not need additional threats of disruption from our state government. We need a leader who will have our backs. We urge Hochul to be that leader.
Elise Nakhnikian, Bobbie Sackman and Michael Solow are members of the New York Caring Majority.
ENYDDA 