Keeping track of the budget battles in Washington, D.C. has become a spectator sport. Sometimes the rhetoric gets so heated and the issues so obscured that it’s tough figuring out what’s actually at stake, let alone how the debate might affect ordinary Americans. But according to this recent NBC News report by reporter Leigh Ann Caldwell, buried in the gargantuan $3.5 trillion Democratic spending bill now being batted about in Congress, there’s at least one program whose funding could have a huge impact on Americans who care for aging loved ones. The proposed bill contains $300 billion earmarked for the expansion of home-based senior care.

“The Hardest Thing I’ve Ever Done”

To explain the challenges of home care, the NBC News feature spotlights the family of 90-year-old Rae Newbaker from Pennsylvania, suffering with dementia and a broken hip. When she could no longer care for herself, she moved in with son Jay, and was soon joined in the household by daughter Paula. “Newbaker needs round-the-clock help to make her meals, cajole her out of bed, assist with her personal hygiene and calm her when her dementia causes hallucinations, which are worse at night,” NBC reports. “Add trips to the doctor, sorting her insurance claims and ensuring she has a social life.”

According to her son, who with his sister provides care for mom, “It’s the hardest thing I’ve ever done in my entire life.” As he explains, “It’s just the stress of taking care of her in the proper manner, which is so hard to do as an adult child, and then the financial burden is always ticking in the back of my head.”

Aging Boomers Create an Explosion in In-Home Care Needs

“The Newbakers aren’t alone,” say NBC. “As the baby boom generation gets older, families are trying to figure out how to keep their parents out of nursing homes — which became even less attractive when COVID-19 ravaged assisted living facilities — while dealing with their growing and expensive needs. And they’re about to become the center of a political fight in Washington.”

As the report explains, the Democrats have “carved out $300 billion to expand home-based care for seniors and the disabled” as part of a mammoth piece of legislation called the American Families Plan, a spending bill with an eye-popping price tag of $3.5 trillion. By giving states various incentives to raise their income caps for aid to 300 percent of the poverty level – roughly $38,600 per person – the proposal would “enable an additional 3.2 million people to be eligible for home-based assistance,” says NBC.  But the GOP isn’t buying it.

“Republicans are digging in, painting the Democrats’ elder care proposal as reckless and too expensive,” says the report. “Democrats think it’s a fight they can win with voters” – especially voters like the Newbaker family.

Caught in the “Twilight Zone”

Jay Newbaker tells NBC News that his family is stuck in the middle, like millions of families just like them. “I call it The Twilight Zone, where we make too much for Medicaid and yet we don’t make enough where we can afford 24/7 high-quality care for my mother,” he said. “So we’re stuck.” The family pays on their own for a 24-hour-per-week home health care aide, and until their mother’s savings are depleted, they won’t qualify for Medicaid. Meanwhile, running out of money for home care is a very real possibility.

The Newbakers’ plight is typical, says NBC News. “For millions of Americans taking care of elderly or disabled loved ones, resources are expensive. Government assistance is provided through Medicaid, but only those with the lowest incomes qualify, and many who qualify don’t get the assistance because many states cap the number of eligible recipients, creating long waiting lists.”  Advocates such as Pennsylvania Democratic Senator Bob Casey say Medicaid needs to be expanded to give more families the ability to afford basic care at home.

Voters Seem to Agree that the Need is Real

According to NBC News, the GOP is fighting hard against the proposal. “Republicans are launching an all-out messaging blitz, accusing Democrats of a ‘reckless tax and spending spree’ and saying the American Families Plan would lead to higher inflation and a suffering economy.” But for their part the Democrats claim to have American public opinion on their side, according to polling conducted for House Democrats by Lake Research Partners. This research, obtained by NBC News, “found that the elder care proposal is one of the most popular components of their agenda among likely Democratic voters.”

Roughly half of poll respondents said they strongly favor expansion of home-based care for the elderly and the disabled. Women, who comprise most of the nation’s caregivers, were among the strongest proponents, as were younger voters and minority voters.

No Guarantee that Home Health Care Boost Will Make the Cut

Whether or not the proposal to expand aid for in-home care ends up in the final legislation is unclear, NBC reports. “Democratic leaders will walk a difficult tightrope over the next few weeks, when they will have to decide what to include in the measure and how much to spend on every category.” The expansive (and expensive) legislation is expected to include money for paid family leave, an extension of the child tax credit and free preschool and community college, as well as aggressive climate change initiatives. Even within the Democratic caucus there is disagreement, with progressives complaining that $3.5 trillion is insufficient, and moderates fretting about the risk of inflation.

At least one member of the House Democrats, Massachusetts Representative Katherine Clark, has firsthand experience with this issue. She cared for her dad, who suffered a stroke, and her mom, who had Alzheimer’s. At the time she was also raising three young children and running for Congress. “Even though I had resources and options, it was really, really challenging to me,” she told NBC News. “And that story plays out for parents and women across this country every day. It is long past time that we recognize how fundamental the care agenda and the care economy is to our economy in general.”

Home Health Care Workers Need Higher Wages, Say Dems

As part of the home health care proposal, the Democrats have also recognized the crisis caused by low wages and a chronic labor shortage. The legislative proposal calls for regulations that proponents claim will guarantee a living wage for home health care workers. Employers will have more stringent reporting guidelines concerning salaries and benefits, and the new law will require that workers be paid at least the minimum wage, set on a regional basis.

The Newbakers of Pennsylvania have experienced the challenges triggered by low industry pay., Their home health aide, Jodi Caye, has been caring for homebound seniors for 25 years and has been with the Newbaker family for nearly two years. Still, she told NBC News, she may have to quit if she doesn’t get more hours or a higher wage soon.

The people out there working at McDonald’s? “They’re making more money than me,” Caye said.

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(originally reported at www.nbcnews.com)