Shah: Washington keeps failing America’s caregivers
**Washington’s Caregiving Crisis: A Call for Action Amidst Political Inaction**
The caregiving crisis in the United States is reaching alarming proportions, yet Washington’s response remains stagnant. With 63 million Americans providing unpaid care to aging relatives, the need for comprehensive support is urgent. Despite the passage of the RAISE Family Caregivers Act in 2018, which aimed to establish a national strategy for family caregivers, it fell short by not allocating any funding to support these initiatives. Other legislative efforts, such as the Credit for Caring Act—which proposes a modest $3,000 tax credit for caregiving expenses—have been repeatedly introduced but have failed to gain traction. The annual funding of just $5 million for the lifespan respite care program serves only a minuscule fraction of family caregivers, highlighting the systemic neglect of this critical issue.
The caregiving landscape has changed dramatically in recent years, with AARP reporting a staggering 20 million increase in caregivers over the past decade, marking a 45% rise. The time dedicated to caregiving has also surged, tripling from an average of nine hours per week in 2020 to 26 hours today. As the demographic shift looms—where older adults are projected to outnumber children by 2030—the pressure on family caregivers will only intensify. The response from Washington has been limited to platitudes and token acknowledgments during National Family Caregivers Month, without any substantive policy changes or investments to alleviate the burden on caregivers.
Neal K. Shah, a healthcare researcher and founder of CareYaya, emphasizes the need for a shift in how caregiving is perceived and supported. He argues that instead of merely celebrating caregivers’ sacrifices, the focus should be on recognizing caregiving as a professional endeavor deserving of training and support. By creating pathways for family caregivers to gain professional credentials and integrating them into the healthcare workforce, the U.S. can address its burgeoning healthcare workforce shortage while simultaneously providing essential support to families. With bipartisan support for caregiving initiatives being a rare opportunity, the time for action is now. As the caregiver support ratio declines, Washington must prioritize this issue before families are left to navigate the crisis alone, potentially leading to a healthcare system overwhelmed by preventable costs and collapsing under its own weight.
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
