A day in the life of a home health-care worker is rough, but intensely intimate: from dawn to dusk, helping seniors take their pills, feeding the wheelchair-bound, occasionally serving as mental-health counselor, physical therapist, or first responder to people with disabilities. Their daily grind occurs far outside the world of politics most days, but home-care aides made an unusually public appearance this week at the Supreme Court by definitively claiming their labor rights. The White House’s extension of federal minimum-wage and overtime standards to this vital but often invisible workforce cleared its last legal hurdle and settled a longstanding legal dispute—laden with patriarchal tradition and gender stereotypes—over whether their work was real work.
The Court’s decision to deny certiori in the case Home Care Association of America v. Weil effectively upholds a lower-court ruling validating a regulatory expansion launched by the Obama administration last year, which extends protections under the Fair Labor Standards Act (FLSA) to home-care workers. The policy change builds on earlier reforms in the 1970s, which granted parallel protections to domestic workers who had been exempted from the original Depression era wage-and-hour laws. The new rule further closes the loophole for home-care jobs, also typically done by women of color, which have steadily professionalized over the years. Home care for seniors and people with disabilities had lagged behind due to an obscure exemption deeming them mere “companions.” The new rule upgrades conditions across the fast-growing health-care profession, which is now poised to absorb an oncoming “gray wave” of active Baby Boomers who are committed to “aging in place” in their communities.
In the lawsuit, the industry association argued that minimum-wage obligations would unfairly affect employers and undermine access to care due to raised costs. Critics of the rule have cited the rationale that since limited Medicaid funding supports long-term care for low-income seniors, “critical services reach more elderly or infirm individuals than they otherwise would precisely because the care-providers are exempt from the FLSA.” They also claim other private households “may also be forced to forego [sic] the option of receiving these services in their homes if the cost of services increases.”
That is, either provide affordable care or pay a fair wage, but not both. The myth of this false choice would never apply when considering the salaries of physicians. But society generally affords less value to the “emotional labor” of home care, even though these services are embedded within an increasingly progressive health-care infrastructure that emphasizes community-based care. Tying the quality and access to low-wages is not only cruel but also counterproductive; the whole idea of fair labor is to ensure worthy wages for decent work.