Hill opinion backs caregivers act

Heather Madden used a Sept. 1 opinion essay in The Hill to argue that the American Caregivers Act should be part of the U.S. response to elder-care shortages. Madden, a vice president for policy initiatives at Independent Women’s Voice, wrote that the proposal is aimed at expanding non-medical, in-home help for older adults without creating what she described as a new federal spending program. The piece lands as demographic and labor pressures on long-term care continue to build. The U.S. Census Bureau has projected that by 2030, one in five Americans will be retirement age, while AARP and the National Alliance for Caregiving said 63 million Americans were caregivers in 2025 and 51 million were caring for an older adult. The Bureau of Labor Statistics said home health and personal care aide jobs totaled about 4.68 million in 2025 and are projected to grow 18% from 2025 to 2035. (thehill.com) ### What exactly did The Hill opinion argue? Heather Madden wrote that current elder-care policy is too rigid and does not match the range of help older adults actually need. In her article, she said some seniors need skilled nursing, while others need lighter support such as meals, transportation, errands, household help, check-ins and companionship. Madden argued that policy should expand the supply and variety of care rather than rely only on additional public spending. (census.gov) She pointed to the American Caregivers Act as a “federal and state legislative model” developed by Independent Women’s Voice, where she works. ### What is the American Caregivers Act? Independent Women’s Voice says the American Caregivers Act would create a sponsor-led program connecting families with caregivers for non-medical, in-home support. (thehill.com) The group says the model focuses on companionship and daily living assistance rather than skilled nursing care. The organization says sponsoring groups would be designated to recruit, vet and place caregivers with families. (thehill.com) Its materials describe the idea as an adaptation of the au pair structure for elder care, with older adults hosting caregivers who provide limited assistance in exchange for room, board and a stipend. ### What problem is the proposal trying to solve? The Hill essay cited cost as a central barrier. (iwvoice.com) Madden wrote that non-medical in-home care averages about $80,000 a year for 44 hours a week and that nursing home care exceeds $100,000 annually. She argued those prices leave few affordable options for elders without family support and can push costs onto taxpayers, especially in residential care. The broader care gap is also tied to aging demographics and limited formal coverage. The Hill reported in January that the United States has no comprehensive caregiving policy, that Medicare does not cover most long-term caregiving needs, and that the country is short of trained and affordable caregivers as the population ages. ### Does this proposal cover medical care? (thehill.com) Independent Women’s Voice says no. Its description says the act “focuses exclusively on non-medical caregiving,” including companionship and help with daily living, not skilled nursing care. That distinction matters because the policy case in Madden’s article is about filling gaps below the level of licensed clinical care. The essay describes support such as meals, errands, transportation and light household tasks, rather than physical therapy, occupational therapy or nursing services. (thehill.com) Any expansion of PT or OT services would depend on separate licensure, reimbursement and workforce rules not set out in the act’s published description. (iwvoice.com) ### Why is the college-student angle central to the plan? Heather Madden wrote that the act would allow seniors to host vetted college students who provide limited assistance and companionship. She said the exchange would give students affordable housing and caregiving experience while offering families a lower-cost option for day-to-day support. Independent Women’s Voice frames that structure as a way to widen the labor pool for elder care without building a new entitlement. (thehill.com) The group’s published materials say the program is intended to create “new opportunities for American students” while making in-home care more accessible and affordable for families. ### Where can readers check the proposal next? Independent Women’s Voice has posted model legislation and supporting materials for the American Caregivers Act on its website. (thehill.com) The Hill opinion by Heather Madden was published on Sept. 1, 2026, and the group’s webpage says the next step is implementation through federal or state legislation using its sponsor-based framework. (iwvoice.com)