Concerns about nursing home ownership and Vice President Kamala Harris' proposal to allow Medicare to cover home health care both reflect the political relevance of concerns that older Americans have, advocates say. (Getty Images)

Caregiving, especially for the elderly, is emerging as an important issue in the November election.

On the same day Democratic presidential candidate Kamala Harris rolled out a plan to extend Medicare coverage to include home care for the elderly, advocates held a press conference to discuss the results of a poll asking Wisconsin voters about their views on long-term care.

“I feel like the issue of long-term care in particular has been this kind of sleeping giant ready to be awoken,” said George Goehl, a community organizer with Addition Action, an advocacy group that focuses on small towns and rural communities around the country.

In Wisconsin, Addition Action has been working with community groups organizing to oppose the sale of county-owned nursing homes to private investors.

In Sauk County, a county home was recently sold to a corporation with several Milwaukee homes over the objections of local residents. In Lincoln County, the sale of a county home to a private investor was halted after community residents mustered widespread opposition.

The poll that Addition Action commissioned included a statewide sample of 400 people age 55 and older, as well as an oversample of 400 rural and small community residents.

Overall, 86% of those surveyed said long-term care costs, including nursing homes and assisted living, were unreasonable, including 57% who called those costs “very unreasonable.” Asked whether the government was doing enough to ensure access to quality, affordable long-term care, 68% said government should do more and 12% said it should do less, while 19% said the government was doing the right amount.

The survey participants gave a mixed assessment when considering private ownership and public ownership of nursing homes.

Public county-owned homes were trusted more by 16% while 35% trusted privately owned homes more. Both groups together, however, accounted for just over half of the survey group.

The remaining 49% were divided nearly equally between people who said they weren’t sure and people who said they trusted — or mistrusted — both kinds of owners equally.

But 64% of people in the survey opposed the sale of public, county-owned nursing homes to private companies, while 33% favored such sales — a margin of 2 to 1.

The survey results are largely bipartisan, according to the polling firm, Hart Research. Majorities of Republicans, independent voters and Democrats said they favored policies including high wages for long-term care workers, eviction protections for nursing home and assisted living residents, expanded access to Medicaid to enable more elderly to obtain long-term care and federal support for public nursing homes.

“Nursing homes are an important part of long-term care, but they are just one part of the care infrastructure we need,” said Judy Brey, who is part of a community campaign that opposed Sauk County’s sale of its public nursing home. Brey spoke on a Zoom call Tuesday to discuss the poll findings.

“This poll tells us that today, most seniors in rural communities like mine don’t believe there is enough affordable, quality long-term care, so the need for long-term care is only going to grow,” Brey said.

Also on the call was Dora Gorski, who has been part of a group in Lincoln County that successfully opposed the sale of a public home there a few years ago. “We know that more can be done to support seniors, especially since we’re growing in numbers in this community and throughout the United States,” Gorski said.

Majorities in the poll also told surveyors that they would view political candidates more favorably who have a plan “to protect public, county-owned nursing homes” from being sold to for-profit corporations.

According to Goehl, in three April 2024 county board elections board members in Sauk, Lincoln and Portage counties who had led efforts to sell county-owned homes to private firms were defeated by candidates opposed to such sales.

“This issue had stirred up a hornet’s nest,” Goehl said in an interview Tuesday.

The poll’s release came on the same day that Vice President Kamala Harris, campaigning for president, announced a proposal to allow the federal Medicare program to cover in-home health care.

Appearing on the television talk show The View, Harris said the expansion would be funded in part by savings that Medicare would receive as a result of negotiating prescription drug prices with pharmaceutical manufacturers.

Harris described the proposal as an effort to meet the needs of “the sandwich generation” — adults who bear the dual responsibilities of raising children and assisting aging parents who are no longer able to live on their own.

Currently, most people who cannot afford to pay for long-term care home services out of pocket can only get that covered through Medicaid — and then they have to divest themselves of most of their assets.

“They have to make themselves poor,” said Haeyoung Yoon, policy director at the National Domestic Workers Alliance (NDWA) a nonpartisan nonprofit for domestic workers including nannies, house cleaners, and home health workers that represents about 400,000 people across the country through local and state affiliate groups.

Home health workers are part of “the fastest- and largest growing occupation in our economy,” Yoon told the Wisconsin Examiner. “We’re going through the  graying of America — baby boomers are aging.”

Yoon said stronger public investment in care, including home health care, is needed so the work pays family-sustaining wages while being affordable to the general public. Currently the average annual wage in the field is less than $22,000 she said, and employees, if they have health care, are likely to be on Medicaid.

Yoon also is part of Care In Action — a separate organization that engages in political advocacy on behalf of the domestic workforce. Speaking in her role as a political advocate, she said the Harris proposal represented an important policy advance.

“It’s a historic and really big deal to say this is something that she wants to do when she’s elected,” Yoon said. 

Robert Codero, 49, of New York City, joined hundreds of advocates on Capitol Hill Wednesday, Sept. 18, 2024, to speak to lawmakers about tax policy ahead of next year’s expiration of the Trump-era tax law. Codero attended as part of the nonprofit Make the Road New York, which also has chapters in New Jersey, Nevada and Pennsylvania. (Photo by Ashley Murray/States Newsroom)

WASHINGTON — Dozens of progressive organizations from across the United States descended on the nation’s capital Wednesday to champion “tax justice” ahead of Congress’ major task of resetting the tax code in 2025.

Led by a coalition named Fair Share America, state and national advocates urged lawmakers to raise the corporate tax rate and ensure those who make over $400,000 annually “pay their fair share.”

Organizers from 20 states fanned out across Capitol Hill, meeting individually and speaking publicly with lawmakers, and testifying before senators.

Kristen Crowell, the coalition’s executive director, said the advocates traveled to Washington to “make sure our representatives know that we know exactly how this tax scam has played out at the local level in our communities.”

“We are getting organized, we are building a multi-racial, multi-sector organization that has real people power on the ground so they can’t cut deals behind closed doors without us holding them accountable,” Crowell said at a large press conference held by lawmakers and advocates outside the U.S. House that eventually thinned out due to rain.

Sen. Michael Bennet of Colorado told the crowd they are the “only antidote there is to the special interests that come to this Capitol.”

“This is the beginning of a long battle that we’re going to have for tax fairness in this country, and we’re really happy that you’re here,” said Bennet, a Democratic member of the Senate Committee on Finance.

Rep. Lloyd Doggett of Texas, a senior Democrat on the tax-writing House Committee on Ways and Means, co-led the press conference and told the crowd to get ready for the “Super Bowl of taxes.”

A group of 61 care-giving advocacy groups among the visiting organizations urged using tax revenue — raised by tax increases on the wealthy — to fund child care, and care for the elderly and those with disabilities.

One of its leaders, Ai-jen Poo, president of the National Domestic Workers Alliance, testified Wednesday afternoon before the Senate Committee on Banking, Housing and Urban Affairs Subcommittee on Economic Policy.

“By asking the wealthiest individuals and wealthy corporations to pay their fair share, lawmakers can leverage the tax code to support robust public investments such as guaranteed access to early education (including child care and pre-K), comprehensive paid family and medical leave, and robust aging and disability care, and good jobs for all care workers,” the Care Can’t Wait coalition wrote in a letter to congressional leadership ahead of the subcommittee hearing.

Harris, Trump tax promises

The advocates’ coordinated visit comes as Vice President Kamala Harris and former President Donald Trump make broad tax promises on the campaign trail ahead of November’s presidential election.

Prior to his Wednesday night rally on Long Island, New York, Trump declared on his social media platform Truth Social that he would lift a $10,000 cap on the state and local tax deduction, otherwise known as SALT. The deduction was part of Trump’s signature 2017 tax law, which is set to expire in 2025.

“WHAT THE HELL DO YOU HAVE TO LOSE? VOTE FOR TRUMP! I will turn it around, get SALT back, lower your Taxes, and so much more,” he posted Tuesday.

A full SALT deduction is more valuable for higher income taxpayers, and prior to the 2017 cap 91% of taxpayers who claimed it lived in California, New York, New Jersey, Illinois, Texas and Pennsylvania, according to an analysis by the Tax Foundation.

Pennsylvania is a key swing state in the presidential race, and several competitive U.S. House races in New York could help decide which party will gain control of the chamber.

Before this change to his platform, Trump had been running on fully extending his 2017 tax law beyond its 2025 expiration date, with the addition of permanently lowering the corporate tax rate even further to 15%.

Analyses from several economists estimate a wholesale extension would add anywhere from $2 trillion to roughly $6 trillion to the national deficit over the next decade.

Trump has also promised to get rid of taxes on tips, Social Security benefits and overtime.

When asked about the effects of Trump’s tax proposals on the nation’s deficit, Republican Sen. John Thune of South Dakota, who is eyeing the position of Senate majority leader if the GOP takes control, told reporters Wednesday, “We’re starting to have some of those conversations already, what impact do some of those changes have? And what does, you know, what are the trade-offs that would happen as a result?”

Harris’ “opportunity economy” platform includes plans to make permanent a pandemic-era expansion of the child tax credit and attach an additional $6,000 credit for new parents. Like President Joe Biden’s budget proposal, Harris also vows to not raise taxes on anyone earning under $400,000 a year.

When speaking to the National Association of Black Journalists Tuesday, Harris revived an earlier Biden administration promise to cap child care costs at 7% of a household’s income.

“If you think about the benefit to the economy overall, it strengthens our economy to do things like pay attention to affordable child care, affordable home health care and extending the child tax credit,” Harris told the association at a discussion in Philadelphia.

The National Women’s Law Center Action Fund, one of the interest groups on Capitol Hill Wednesday, said Harris’ plan would be “transformative” for families.

Harris also promises to increase the corporate tax rate to 28% from the current 21%; tax long-term capital gains at 28%; give a $25,000 tax credit to first-time home buyers; and give new small businesses a $50,000 deduction for start-up costs. She has also embraced the promise to end taxation on tips.

Organizers on Capitol Hill Wednesday represented groups from Arizona, Colorado, Connecticut, Iowa, Maine, Maryland, Michigan, Minnesota, Montana, Nebraska, New Hampshire, Nevada, New Jersey, New York, Pennsylvania, Vermont, Virginia, West Virginia, Washington, and Wisconsin.

Jennifer Shutt contributed to this report.