Shah: Washington keeps failing America’s caregivers
Washington is facing a significant caregiving crisis, marked not only by the 63 million Americans providing unpaid care to elderly relatives but also by the government’s chronic failure to address the issue effectively. Despite the passage of the RAISE Family Caregivers Act in 2018, which aimed to establish a national strategy for supporting family caregivers, it has not led to any meaningful funding or actionable support. Other initiatives, such as the Credit for Caring Act—which proposes a modest $3,000 tax credit for caregiving expenses—have been repeatedly introduced without any progress. The situation is exacerbated by the inadequate $5 million annual funding for the lifespan respite care program, which serves a minuscule fraction of family caregivers. As caregiving demands have surged, with AARP reporting a 45% increase in caregivers over the past decade and a tripling of average caregiving hours since 2020, the lack of governmental response has become increasingly glaring.
The political landscape surrounding caregiving is characterized by bipartisan dysfunction, with both parties failing to prioritize this pressing issue. Republicans often block investments in essential areas like respite care and workforce development, while Democrats propose expansive programs that lack budgetary feasibility. This inaction has profound implications, as highlighted by former Surgeon General Vivek Murthy, who classified caregiver burnout as a national public health emergency. Caregiver fatigue leads to increased healthcare costs and emergency room visits, contributing to billions in preventable spending. Instead of creating new programs, there is a pressing need to recognize and professionalize the existing caregiving workforce. Research indicates that over half of family caregivers are interested in professional training, which could alleviate the healthcare workforce shortage while providing necessary support to families.
As we approach 2030, when older adults are expected to outnumber children for the first time in U.S. history, the urgency for action is paramount. The caregiver support ratio is projected to decline dramatically, signaling an impending crisis for families and the healthcare system. During National Family Caregivers Month, political leaders may issue statements honoring caregivers, but without tangible actions to support them. The solution lies in funding training programs, creating professional pathways, and treating caregiving as legitimate work. The time for Washington to act is now; otherwise, the consequences of inaction will fall heavily on the shoulders of millions of American families already stretched thin by the demands of caregiving.
Washington has a caregiving problem. And I don’t mean the 63 million Americans in crisis providing unpaid care to aging relatives. I mean, Washington’s chronic inability to do anything about it.
Multiple caregiving bills sit in committee purgatory, languishing for years.
The RAISE Family Caregivers Act was passed in 2018, establishing a national strategy to support family caregivers, but it did not provide funding.
The Credit for Caring Act, providing a modest $3,000 tax credit for caregiving expenses, has been reintroduced session after session with no movement.
The lifespan respite care program receives $5 million annually, enough to serve 0.008% of family caregivers.
Meanwhile, the caregiving crisis has exploded nationwide. AARP’s 2025 report shows that caregiving surged by 20 million people in a decade, representing a 45% increase. The average weekly caregiving time has tripled since 2020, from nine to 26 hours. By 2030, older adults are expected to outnumber children for the first time in U.S. history.
And what has Washington’s response been? Thoughts, prayers and “National Family Caregivers Month.”
I’ve watched this failure from multiple vantage points. As someone who cared for my wife through cancer, after caring for my grandfather through dementia, I know the impossible math of caregiving. As founder of CareYaya, one of America’s largest caregiving platforms, and a researcher leading NIH-funded studies on caregiver training, I see how federal policy failures cascade into chaos for families.
The political dysfunction is bipartisan and equally maddening. Republicans block any meaningful investment in respite care, training programs or workforce development. Democrats propose expansive programs such as universal paid leave that aren’t budget-conscious and often go nowhere. Both parties miss what’s sitting right in front of them.
Former Surgeon General Vivek Murthy got it right in his 2022 advisory, which positioned caregiver burnout as a national public health emergency. When caregivers are depressed or fatigued, there’s a 73% increase in emergency room use and nearly $2,000 in additional medical costs per patient. We’re hemorrhaging billions in preventable healthcare spending because we refuse to invest in caregiver support.
The solution isn’t more government programs. It’s recognizing an existing care workforce and treating them like professionals. Research shows that more than 56% of family caregivers are interested in training to work professionally, caring for patients in other households. We can create a workforce development pathway for millions of Americans who already do this work, want professional credentials, and could fill America’s healthcare workforce shortage.
It’s the infrastructure bill model applied to human infrastructure: create federal funding for caregiver training and credentialing; partner with community colleges for certification programs; provide professional pathways and let Medicare and Medicaid reimburse for trained family caregivers.
The economic case is overwhelming. We spend $5.6 trillion annually on healthcare, but family caregivers provide $600 billion in unpaid care. We’re running a healthcare system that depends on extracting free labor from families until they collapse.
The political case should be equally obvious. Caregiving is a rare issue with an actual bipartisan constituency — red states and blue states are similarly affected.
So why does nothing happen?
Because caregiving falls between every committee’s jurisdiction. It’s health policy, but also labor policy, family policy and aging policy. It’s everyone’s problem — and no one’s priority.
Meanwhile, the demographic wave approaches. By 2030, the “caregiver support ratio” of middle-age people in society to support every older adult drops from 7:1 to just 4:1. The system that’s already failing will face impossible demands.
During National Family Caregivers Month (November), both parties will issue statements celebrating caregivers’ sacrifices, host events and use the word “hero” a lot. Then they’ll return to D.C. and do exactly nothing.
Here’s a radically different idea: instead of celebrating caregivers’ sacrifices, let’s reconsider the expectations placed on them. Fund training programs. Create professional pathways. Recognize care work as real work. The legislative vehicle doesn’t matter — reconciliation, stand-alone bills, whatever. However, the window is closing.
In 2030, when older adults outnumber children for the first time, Washington will have two choices: point to a caregiving workforce we invested in and professionalized, or point fingers at each other while families drown.
Right now, we’re on track for the latter. And 63 million Americans are paying the price for our dysfunction.
Neal K. Shah is a healthcare researcher specializing in workforce innovation and AI-enabled caregiver training/InsideSources
