Most Americans are aware of the heated political debate about the influx of unaccompanied migrant children caught at the southwest border. The U.S. Department of Homeland Security has called this an “urgent humanitarian situation.” But, there is another pressing crisis related to immigration policy: the undermining of the nation’s elder-care systems.
It’s surprising that the issue has fallen under the radar. Our nation is dependent on U.S.-born Latinos and immigrants from Latin America to sustain a robust economy. Although Latino workers contribute millions in federal income, property, sales and excise taxes that support American retirees, they have remained outside of the economic and social mainstream.
This fact has serious implications for both the young and the old, especially as the Latino population ages rapidly along with the rest of the population. Nationwide, and particularly in Texas, a convergence of increasing numbers of culturally distinct immigrant elderly people and shrinking numbers of working-age people is influencing who will care for older adults in years to come.
Some evidence suggests states such as Texas and California, with high proportions of Latino immigrants, will confront major challenges of coping with intergenerational interests in an age-ethnically stratified society. The growing working-age Latino population will bear much of the retirement cost of the non-Latino white population. As the result of the electoral clout of English-speaking non-Latino white retirees, we should anticipate widespread support for initiatives that disproportionately affect immigrants of Mexican descent. Proposals for tougher border security measures along the U.S.-Mexico border are just one example of congressional action to limit unlawful immigration. Still, the Republican leadership in Congress recognizes that the current immigration system is broken, but has no plan for giving legal status to the 11 million undocumented workers in the nation until the midterm elections are over.
To understand the politics of comprehensive immigration reform and its history, look at California during the 1990s. Approval ratings soared for Gov. Pete Wilson as a result of the passage of laws that denied immigrants access to health and economic benefits, abolished affirmative action/racial quotas and restricted bilingual education. Clearly these types of state legislative proposals are aimed at restricting or eliminating program eligibility and some essential health benefits, including state-funded social services supporting elderly immigrants.
Elderly Latinos are far less likely than non-Latinos to enter a nursing home, and as result, most older Mexican Americans receive long-term care in the community, relying exclusively on unpaid family caregivers. Such an economic obligation represents only one of the potential responsibilities that family caregivers assume. It will be essential to close the educational gaps between Latinos and non-Latino whites in the future to improve their financial outlook.
Who, then, will care for us as we grow old and frail? At the federal level, it is likely that nothing will be done until after November. But at the state and local levels, some new developments are promising. For example, the Texas Legislature is working to find new ways to provide culturally appropriate care for frail and disabled persons. In June, the Texas House Appropriations Subcommittee convened to study the implementation of certain provisions in the Program of All-Inclusive Care for the Elderly (PACE). The hearing made recommendations for expanding and improving the delivery of Medicaid long-term care services.
As Texas and other states move forward, it will be important to determine how experiments in community-based long-term care, such as the PACE model, could be introduced to local communities. PACE provides a continuum of community-based services in El Paso, Amarillo and Lubbock for individuals age 55 or older who need nursing home care. Although Texas seniors prefer to live safely in the community for as long as possible, many cities are without these options. We have an opportunity to develop innovative initiatives to reduce caregiver burden for the most vulnerable seniors, including Latino immigrant families. Creating a model adapted to the local community of ethnically disadvantaged elders is a step in the right direction. Our immediate goal should be to consider the best use of Medicaid funding for our families and to leave politics aside.
Jacqueline Angel is a professor of sociology and public affairs at The University of Texas at Austin. Her most recent book, co-authored with Ronald Angel, is “Latinos in an Aging World” (Rutledge).
A version of this op-ed appeared in the Corpus Christi Caller Times and Beaumont Enterprise, among others.
