Home care workers could lose wage protections under Trump : NPR
More than 3 million home care workers could lose the right to overtime and the federal minimum wage under a rule proposed by the Department of Labor.
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Caring for the elderly in America is expensive – too expensive for many people.
Now the Trump administration is trying to solve this problem by reducing wage protections for more than 3 million workers who care for elderly and disabled people at home.
The Labor Department has proposed repealing an Obama-era rule that extended Fair Labor Standards Act coverage to home care workers. The 2013 rule gave them labor protections that most other workers have enjoyed since 1938.
These include the right to earn at least the federal minimum wage of $7.25 an hour and overtime, paid at one and a half times their regular rate when working more than 40 hours per week. At the time, the Department of Labor said the change would fulfill President Obama’s promise to “ensure direct care workers receive a fair day’s pay for a fair day’s work.”
The Trump administration says the rule has not produced the expected benefits but has instead created problems, harming employers, workers and the families they serve.
Labor advocates counter that removing wage protections will drive even more workers out of a sector that already sees about 80 percent annual turnover.
Industry group says rule led to unintended consequences
A lawsuit filed by the Home Care Association of America, which represents 4,300 home care agencies across the country, delayed but ultimately did not block implementation of the 2013 rule.
After it took effect at the end of 2015, the industry group says, workers saw their incomes drop. Rather than pay overtime, home care agencies have limited workers to 40 hours per week to reduce costs for families who pay for care themselves and for states that cover home care through Medicaid.
As a result, caregivers who worked 60 to 70 hours per week for a single family took other jobs with other agencies to make up for lost income, disrupting long-term relationships with families. Meanwhile, home health agencies have spent more time and money recruiting, hiring and training additional workers, according to the industry group.
Caregiver advocates say overtime has never been common in the industry. Only about 10% of caregivers worked more than 40 hours per week before the Obama rule took effect, according to PHI, a nonprofit research and advocacy organization focused on improving caregiver wages.
With the plan to roll back the Obama rule, Kezia Scales, vice president of research and evaluation at PHI, says the Trump administration is signaling that home care workers — 85 percent of whom are women and two-thirds people of color — don’t deserve basic job protections.
“We’re talking about stripping away the hard-won labor rights of our nation’s largest workforce and the one that arguably provides some of the most essential services for ourselves and our loved ones,” she says.
An industry marked by low wages
When Congress passed the Fair Labor Standards Act in 1938, domestic workers were excluded from welfare coverage in order to gain votes from Southern Democrats. In 1974, Congress amended the law to extend coverage to some domestic workers, but continued to exclude babysitters and those providing “accompaniment services.”
According to the Obama Labor Department, the work of professional caregivers goes far beyond simply keeping people company and monitoring their well-being.
“It’s real work, but it continues to be seen as not real work,” says Haeyoung Yoon, vice president of policy and advocacy at the National Domestic Workers Alliance.
Marilyn Blackett has been caring for the elderly in New York for more than two decades. She says it’s not an easy job.
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Marilyn Blackett certainly considers herself more than a companion to her elderly clients. They usually need help eating, bathing and using the toilet. Some need wound care. Others required palliative care.
“It’s not an easy job,” says Blackett, who learned to be a caregiver at an early age, caring for her grandmother at her home in Trinidad and Tobago.
Her salary of less than $20 an hour is not enough for her in New York, where she has lived and cared for the elderly for 24 years.
“Pay the rent, pay the bills, buy food, and when you finish, you’re left with nothing,” says Blackett, who is now 63 and thinking about when she might be able to retire.
In 2024, the national median wage for home care workers was $16.78 per hour, according to the Department of Labor. PHI estimates that half of caregivers rely on some form of public assistance.
“They’re not making decent wages,” Scales says.
The Home Care Association of America does not dispute that wages are low.
“I think everyone agrees that caregivers are angels and the work they do every day for our seniors is invaluable,” said the group’s legislative director, Cheryl Stanton, who led the Labor Department’s Wage and Hour Division during the first Trump administration. “We would all like caregivers to be paid better.”
But the challenge, according to Stanton, is limited funds. Medicaid subsidizes elder care only for the lowest-income seniors, and states are not required to cover home and community-based care at all. Some states only cover care in facilities such as nursing homes. Most families pay for care themselves.
“They can’t afford to pay overtime to provide care,” she says.
$158 million in salary arrears
Scales, the PHI researcher, acknowledges that affordability is an issue. And with Medicaid funding cut under Trump, she fears the situation will only get worse.
With the population aging rapidly, she says the United States needs to think about how to finance care.
“Marginalizing and further devaluing the workforce that provides the services is simply not the solution,” says Scales. “They shouldn’t carry this affordability issue on their own shoulders.”
Importantly, Scales says, being covered by the Fair Labor Standards Act means home care workers can file complaints when employers fail to meet overtime pay or minimum wage requirements. PHI’s analysis of Department of Labor compliance data found that home health agencies have paid workers nearly $158 million in back wages since Obama’s rule took effect.
“Countless people have likely benefited from their employers’ proactive compliance,” says Scales.
Demand for home care workers will skyrocket
PHI estimates that the home care workforce will create 681,000 jobs over the next decade.
Amanda Kreider, a health economist at the University of Pittsburgh, says removing labor protections at such a time doesn’t make sense.
“It would be one thing if we had tons of workers ready and willing to do this work,” she says. “I just don’t think you can increase access in a situation where there is a serious labor shortage by reducing the quality of jobs.”
In Brooklyn, caregiver Blackett agrees that it will become even harder to find workers if protections are removed. Already, she says, no American wants to do this work.
New York’s home care workers are actually in a better situation than most. The state has its own Domestic Workers Bill of Rights, which guarantees overtime pay and minimum wage to workers, even if they are no longer covered by the Fair Labor Standards Act.
Still, Blackett says, home care workers deserve better.
“It’s work and we need to be recognized as workers,” she says.
