Caregiving is “the work that makes all other work possible.” It’s also underpaid, undervalued, and in need of investment.

This week, a bus tour building political pressure around issues like paid medical leave and higher wages for caregivers made its final stop in Atlanta—the birthplace of the domestic workers’ movement

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Ai-Jen Poo is the executive director of Caring Across Generations and the president of the National Domestic Workers Alliance. One of the country’s leading advocates for care workers—and a 2014 recipient of the MacArthur “genius” grant for her efforts in this area—Poo served as emcee at Saturday’s event. | Photo: Sam Worley

“If I could get everyone here to just take a moment,” said Jacqueline Lamar, surveying an energetic crowd gathered on a recent morning in a Mechanicsville parking lot. “Look to your left and look to your right.” At some point in their lives, Lamar pointed out, everyone present will require care of some sort: They’ll become old, they’ll suffer an injury, they’ll develop a disease or disability. Everyone, too, might someday become a caretaker—to a young child, for instance, or an aging parent.

The bus parked for a rally outside the IBEW Local 613 building, which shielded the crowd from the hot morning sun. | Photo: Sam Worley

And yet caregiving is deeply undervalued in the U.S., the only wealthy country in the world with no federally mandated paid family or medical leave. As a profession, caregiving is also desperately underpaid. That was the message of the event where Lamar delivered her remarks: the final stop on a bus tour called Care Can’t Wait, which aimed to draw attention to the plight of care workers, and to build political pressure for things like higher wages, healthcare access, and unionization. The tour had begun a few days earlier in Chicago before wending its way through cities including Detroit and Philadelphia, and North Carolina’s Research Triangle area.

Lamar, who lives in Covington, is a member of the National Domestic Workers Alliance—part of the Care Can’t Wait Coalition, a group of advocacy organizations and unions that sponsored the bus tour. She got into care work while looking after an aging grandmother.

“She had insufficient insurance,” Lamar said, wryly. “You know the kind—where you get a Band-Aid and a little cup of juice? So my family had to rally around her and take care of her.” Nobody in the family really knew how to do this kind of work, but the experience inspired Lamar to go to school to learn. She learned, subsequently, that she’d be paid $9 an hour at the agency that eventually hired her, where she found herself doing things like administering medications—tasks beyond her training, but that she and her colleagues performed anyways.

“She had insufficient insurance. You know the kind—where you get a Band-Aid and a little cup of juice? So my family had to rally around her and take care of her.” —Jacqueline Lamar, member of the National Domestic Workers Alliance

A marching band from Jonesboro High School—and a school troupe called the Majestic Dancing Dolls—provided entertainment. | Photo: Sam Worley

While employed as a care worker, Lamar couldn’t afford childcare of her own, leaning on neighbors and family members to look after her kids while she made a living. “You can’t get nothing with $9 an hour, right?” she said. Several years after her grandmother died, Lamar suffered a stroke, as she wrote last year in the Atlanta Journal-Constitution—meaning it was her turn to need care, in this instance from her daughter. “This cycle, where the lines between caregiver and care recipient blur, is a testament to the crucial need for empathetic investments in our care infrastructure that supports Georgians in every stage of life,” Lamar wrote.

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Care work is “the work that makes all other work possible,” said Ai-Jen Poo, the executive director of Caring Across Generations and the president of the National Domestic Workers Alliance. One of the country’s leading advocates for care workers—and a 2014 recipient of the MacArthur “genius” grant for her efforts in this area—Poo served as emcee at Saturday’s event. “We’re living longer, and we’re needing more care than ever before as a country,” Poo said. “But instead, we have care workers—home care workers, for example—who earn on average $23,000 a year.”

“We have care workers—home care workers, for example—who earn on average $23,000 a year.” —Ai-Jen Poo, executive director of Caring Across Generations and president of the National Domestic Workers Alliance

One reason Atlanta was an appropriate final stop, Poo said, was the city’s history as “the home and birthplace of the domestic workers’ movement.” She was referring to Dorothy Bolden, a Black woman who began working at age nine, in 1933, in the home of a white family in Vine City. As an adult, Bolden was moved by decades of low pay and mistreatment, and by the example of the civil rights movement, to begin advocating for herself and her fellow domestic workers. In 1968, after seeking the advice of a Vine City neighbor—Martin Luther King Jr.— she helped found the National Domestic Workers Union of America, growing the group into a potent political force while serving as its leader for three decades.

Martresa Graves, of the workers’ rights organization 9 to 5, spoke about trying to keep a job while supporting both a mother and daughter with medical needs—and then becoming sick herself. | Photo: Sam Worley

Bolden died in 2005 and, while the treatment of Black domestic workers may be better than it was in pre–civil rights Georgia, advocates say there’s a long way to go. At Saturday’s event, speaker after speaker testified to the impossible task of balancing care with the cost of living. Martresa Graves, of the workers’ rights organization 9 to 5, spoke about trying to keep a job while supporting both a mother and daughter with medical needs—and then becoming sick herself. Whom do you prioritize? “Do I care for my mother? She’s the reason I’m here on the planet Earth,” Graves said. “Care for my child? I’m the reason she’s here on Earth.”

State Rep. Sam Park spoke of his late mother, whose medical expenses reached $30,000 a month after she was diagnosed with cancer. “It was only because she had access to public health insurance—Medicaid and Medicare—that she had a fighting chance,” Park said, while acknowledging that his mother was “also lucky—she had myself and my two sisters to provide her care around the clock.”

“It was only because she had access to public health insurance—Medicaid and Medicare—that she had a fighting chance.” —State Rep. Sam Park

State Rep. Sam Park spoke of his late mother, whose medical expenses reached $30,000 a month after she was diagnosed with cancer. | Photo: Sam Worley

The Care Can’t Wait Coalition is asking for federal action, like the passage of paid family and medical leave legislation and investment in Medicaid Home and Community-Based Services, which allows people with disabilities to receive support in their own homes and communities, rather than be institutionalized. Currently, Medicaid pays for care in nursing homes and other institutional settings, but only for home and community care if the recipient obtains a waiver—and the waiting list for such waivers is long. In 2023, Poo’s organization Caring Across Generations celebrated the introduction in the U.S. Senate of legislation that would eliminate waiting lists and extend services to some 1 million Americans. It has yet to pass.

The problems of care are particularly acute in this region, as Dom Kelly, the cofounder of New Disabled South, mentioned: “We have a crisis here in the South,” Kelly said. “In this country we have 700,000 people on waiting lists for home and community-based services waivers. The South has 75 percent of that waiting list,” he said, including more than 7,000 people in Georgia, some of whom have been waiting up to 20 years.

“We have a crisis here in the South. In this country we have 700,000 people on waiting lists for home and community-based services waivers. The South has 75 percent of that waiting list.” —Dom Kelly, cofounder of New Disabled South

Following the previous legislative session, Governor Brian Kemp signed a law increasing wages for care workers and creating new slots for Medicaid waivers for people with disabilities—but only 100 new slots, Kelly mentioned, just a small fraction of the thousands on the waiting list.

And Kemp, along with Republican governors in 10 other states, has steadfastly refused to expand Medicaid—which would extend healthcare coverage to nearly half a million Georgians, with the majority of the funding coming from the federal government. The prospect of Medicaid expansion is a perennial topic of conversation among Georgia lawmakers, some of whom have been trying to get it done for years, as Rep. Park said: “But we are not there just yet.” •