Caregivers in Connecticut are calling on state officials for better conditions and higher pay.
They're seeking a $25 an hour minimum wage, paid time off, affordable healthcare, and a pension for retirement planning.
Chase Bolling is a Personal Care Attendant and member of 1199 Service Employees International Union Northeast.
Originally, he was a machinist, but became a PCA because it wasn't easy to juggle caregiving for his mother-in-law with his full time job.
Bolling said any improvements to caregiver's working conditions must begin with better funding.
"I think the foremost thing would be increasing our budget," said Bolling. "You know, nothing happens in this world without money and you kind of can't take any steps forward or any initiatives towards improving our conditions without first improving our pay, and providing access to benefits."
He added that better funding will be able to provide long-term job security.
Along with PCA's, unpaid family caregivers are facing similar challenges.
According to an AARP report, unpaid family caregivers across the U.S. provided care valued at $600 billion in 2021. That's a $130 billion increase over 2019.
During the Covid-19 pandemic, PCA's - like many of Connecticut's healthcare workers - were dealing with strained working conditions.
During the first few months of the pandemic, there was a shortage of personal protective equipment.
While many healthcare providers have fought for and seen changes in their working conditions, Deidre Murch - vice president and homecare director for SEIU 1199 Northeast - said it hasn't been the same for PCA's.
"What we see is that there are a lot of examples where PCA's have been treated, literally, as invisible," said Murch, "without any of the same recognition or support in wages and benefits as other healthcare providers have."
From here, Murch added that it's now up to state elected officials to take bold steps in uplifting this workforce out of poverty-inducing wages and lacking benefits.
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As Mississippi lawmakers move forward with a potential Medicaid expansion, advocates said the state cannot afford further delays while thousands remain without health care.
Two so-called "dummy bills" are advancing through the House and Senate Medicaid committees, but the policy remains in limbo as legislators wait for clarity from Washington, D.C.
Kimberly Campbell, state director for AARP Mississippi, has been working on Medicaid expansion for several years and said the fight is far from over.
"There still needs to be some more discussions to figure out how can we get something that moves the state forward as far as access to health care," Campbell emphasized. "Access to quality health care for more individuals than we have now that are covered under any type of health program."
Mississippi is one of 10 states to have not expanded Medicaid under the Affordable Care Act, leaving an estimated 125,000 Mississippians without access to affordable health care. While last year's legislative session saw historic movement, expansion failed in the final hours as House and Senate leaders clashed over the details.
Advocates like Campbell argue expanding Medicaid would have far-reaching effects, including boosting the state's economy, strengthening rural hospitals and improving public health.
"Mississippi, unfortunately, we have some of the worst health outcomes here in the state," Campbell pointed out. "That would change a lot of those things. That would change our life span, and not only just the years of life but the quality of the years of life."
Gov. Tate Reeves remains firmly opposed to expanding Medicaid in Mississippi. In his recent State of the State address, he reaffirmed his stance against broadening coverage, citing concerns potential federal policy changes under President Donald Trump's administration could increase state costs for expanded welfare programs.
Reeves has consistently referred to Medicaid expansion as "welfare" and has resisted efforts to increase enrollment, despite growing support from key Republican legislative leaders.
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Florida residents who depend on Medicaid said they fear for their futures as lawmakers consider $2.3 trillion in federal cuts, which could force states to reduce services, cut eligibility or lower provider payments.
The proposal, first reported by Politico, has drawn opposition from health advocates who said the reductions would hit hardest among children, seniors and people with disabilities.
During a news conference organized by the Florida Policy Institute, Virginia, a Medicaid recipient in Alachua County, shared how the program has given her independence despite living with a disability.
"If Congress was to cut Medicaid or government was to cut Medicaid. I don't know how I would live," she said. "I have no family to go to. Both my parents are low-income housing. My father is pretty much disabled. He cannot help me at all. My mother is not in the picture."
The potential cuts include $9.8 billion in per capita reductions to cap how much funding Florida could receive. Proponents have suggested reducing federal Medicaid funding would compel states to make more prudent decisions regarding their health care budgets.
Joan Alker, executive director of the Georgetown University Center for Children and Families, warned these cuts would leave states with difficult choices.
"Cuts of this magnitude would force states to make very painful choices about cutting services, cutting benefits, reducing payments to providers, cutting eligibility," she said.
For the Rev. Latifah Griffin, whose 10-year-old son has cerebral palsy, Medicaid makes it possible for him to access specialized care, mobility devices and a pediatric extended care facility.
"I would literally struggle to take care of him," Griffin said. "I would likely need to quit my job because I would need to stay home due to being able, unable to afford the services for him without Medicaid. Then, I too will become a burden on an already broken system."
Medicaid serves 2.4 million Floridians, covering two of every five children in the state. A nationwide outage in government payment processing systems temporarily froze Medicaid funding to states, causing widespread confusion. The crisis followed President Donald Trump's recent executive orders, which briefly paused federal spending on various programs, excluding Medicare and Social Security.
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Changes could be coming for Arkansans who are on Medicaid.
Gov. Sarah Huckabee Sanders is proposing to add work requirements for some Medicaid recipients. Similar rules were imposed in the state in 2018 but later struck down by the Biden administration.
Neil Sealy, senior organizer for Arkansas Community Organizations, said more than 18,000 people lost coverage seven years ago although they were working or had been granted exemptions.
"We reached out to people to speak with them about their experience," Sealy explained. "There was a reporting requirement, and if after three months if you had not reported, then you would be taken off. "
He noted some recipients were unaware they did not have coverage until they tried to go to the doctor. Sanders is hopeful the requirements will remain in place under the new Trump administration.
According to a report in Forbes Magazine, Arkansas is the fourth-least healthy state in the country. Around 820,000 Arkansans are on Medicaid.
Specific details about Sanders' proposal have not been released but she said she wants a broader requirement to cover able-bodied adults. Sealy noted their volunteers are already mobilizing.
"We get ready," Sealy emphasized. "We are reaching out to people in the community. We are going to be on the doors, talking in churches, getting ready. We don't sit down and take it. "
A Harvard study showed in 2018 the work requirements did not decrease unemployment and red tape and paperwork created serious hurdles for people who were eligible for coverage.
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