As the age of the US population continues to rise – and millions of people with disabilities, additional needs and children need care – so too does the country’s insatiable demand for home healthcare and domestic workers. But years of underinvestment in the sector, and the chronic undervaluing of the important work carried out disproportionately by women of colour (particularly those with an immigrant background) has left the sector in a perilous state.

It is a situation that has a deep and shameful history, rooted in the fact that enslaved African-American women were forced to provide unpaid household care for white families during the period of human chattel slavery that operated in the United States from its founding in 1776 until 1865. Following the abolition of slavery, the low wages and poor conditions of domestic work was sustained by a series of violent, racist laws known as ‘Jim Crow’.

Against this backdrop, when it passed the US Congress in 1935, the National Labor Relations Act recognised the collective bargaining rights of US private sector workers and established a process to require employers to bargain with their unions. The law carried a political price, however. Racist senators and congressional representatives in the Democratic Party (known as Dixiecrats because they were all from the US South, or from ‘Dixie’) demanded exclusions. Domestic workers, who were still largely African-American women, would not be covered. Neither would farm workers, mostly Mexican and Filipino immigrants in that era.

The Fair Labor Standards Act, passed three years later, gave private sector workers the right to overtime pay and minimum wages. Again, domestic workers and farm workers were left out, at the insistence of Dixiecrats. It is no accident, therefore, that the labour rights and wages of both groups were held far below those of other workers in the decades that followed. Yet despite the exclusion, farm workers continued to organise. And in the last few decades, domestic workers have sought to end their exclusion as well.

Organising locally, nationally and globally

In California and other states, rising activism accompanied the increase of immigrant workers in the domestic worker labour force. According to labour historian Jennifer Guglielmo: “In the 1970s and 1980s, the domestic workforce began to change dramatically. African-American women moved out of domestic labour in large numbers and into clerical, sales, public sector, and professional jobs. Mexican-American women in the south-west also left domestic work for these jobs [...]. This shift led employers to hire more immigrant women from Latin America, the Caribbean, and Asia in much larger numbers.” This wave of migration was in part the product of the displacement of families and communities in countries forced to adopt neoliberal structural adjustment policies and free trade agreements.

In the 1990s, immigrant domestic workers in urban centres began to organise community-based workers’ centres. San Francisco’s Mujeres Unidas y Activas started as a project of the Northern California Coalition for Immigrant Rights, for example, while the Colectiva de Mujeres was originally a women’s centre within the city-sponsored Day Labor Program. In the early 2000s they joined, first with Bay Area organisations like Filipino for Affirmative Action, and then with Southern California organisations like the Coalition for Human Rights in Los Angeles and the Filipino Workers Center, to form a statewide network. This process paralleled others in New York and other states. In 2007, five California organisations joined six from New York and one from Maryland to form the National Domestic Workers Coalition which just a few years later played a key role in the adoption of a landmark international labour standard for domestic workers in 2011, International Labour Organization Convention 189 on Decent Work for Domestic Workers, which recognised for the first time the right to minimum working standards for domestic workers.

Following a dynamic campaign by an alliance of trade unions and domestic worker organisations, C189 has since been ratified by 36 countries; the United States, however, isn’t amongst them.

When the California Domestic Worker Coalition put a Domestic Workers Bill of Rights on the state legislature’s agenda in 2012 (following a watershed Domestic Workers Bill of Rights passed in New York in 2010), then-AFL-CIO president Richard Trumka recognised the historic justice of their demands. “It’s not right that domestic workers should be excluded from overtime pay laws,” he told a crowd in Washington DC. “It’s time for that to end. It’s not right that domestic workers are excluded from collective bargaining laws. It’s time for that to end. Domestic workers’ rights are civil rights. Domestic workers’ rights are human rights.”

Trumka responded to the stories he was hearing from workers who’d come to push for the bill’s promise of racial and labour equity. Teresita Gao-Ay, a domestic worker from San Diego, told him she’d been a caregiver since 1986, working from 7am to 9pm. “I had to do everything from cooking, cleaning the whole house, laundry that had to be pressed and folded, including sheets, gardening and caring for the dog. And I had to do this for the whole family, not just for the client I was taking care of. But how can you say no? I was living in their house. Plus, they said they’d call the police if I didn’t do as they asked. Then, when I was injured on the job, no one paid me for the days I had to take off to recover.”

“Care workers deserve to make a decent living”

The Covid-19 pandemic brought the plight of care providers into sharp focus everywhere, but in the US, where resources in the care sector were already stretched thin, the situation has worsened as a result of thousands of experienced care workers either leaving the sector or losing their lives after contracting Covid. According to the AFL-CIO: “Care prices have also skyrocketed, straining working families and forcing them to spend a significant portion of their income on services.”

When President Joe Biden issued an executive order in April this year, seeking to use the administrative power of the federal government to raise domestic, home care and child care worker wages and make the care they provide to working families more affordable, he implicitly recognised the historic injustice. “Care workers deserve to make a decent living, and that’s a fight I’m willing to have,” he declared.

“No one should have to choose between caring for the parents who raised them, the children who depend on them, or the paycheque they rely on to take care of both.”

The executive order contains a number of directives to different parts of the federal government, covering the programmes they administer. The Department of Health and Human Services, for instance, was told to consider actions to reduce or eliminate families’ co-payments for childcare. Other agencies were directed to identify which of their grant programmes can support childcare and long-term care for individuals working on federal projects. The order calls for increasing the pay of Head Start teachers and childcare providers, a federally and state-funded programme for early childhood education.

The order seeks to ensure there are enough home care workers to provide care to seniors and people with disabilities enrolled in Medicaid, which provides free or low-cost health coverage to low-income families and individuals. It proposes to set minimum staffing standards for nursing homes, as well as conditioning a portion of Medicare payments on how well a nursing home retains workers. “This will be the first time that we’ll have a care standard,” explains Mia Dell, deputy director for advocacy at the AFL-CIO.

This development also aligns with demands from the international labour movement for greater investment in care to ensure equitable access to quality public care and health services. “It advances the social equity goal of the executive order, because the nursing homes with the worst history are those serving low-income communities of colour.” Better staffing standards and pay would also benefit the workers of colour and women making up most of that workforce, another equity component of the order, Dell says.

The President’s statement announcing the executive order highlighted the budget proposals intended to advance these goals. The American Rescue Plan, which provided funding to overcome the impact of the pandemic, contained over US$60 billion for care issues. The administration statement credited that funding with saving the country’s system of private childcare providers. The Biden Budget, if adopted, would include US$150 billion over ten years to expand Medicaid home services, and proposes US$600 billion over ten years for expanded childcare and preschool programmes. However, it faces extreme Republican opposition in Congress.

Historic exclusion

Today, the consequences of the historic exclusion of domestic workers run deep. In 2022 the Economic Policy Institute (EPI) issued a report, the Domestic Workers Chartbook, that outlines the basic living and working conditions for the 2.2 million domestic workers in the United States. That number is expected to grow rapidly – more than three times as fast as employment in other occupations – because the ageing of the US population and workforce is expanding the number of people needing care.

The real size of the workforce is likely larger, the EPI says, because many domestic workers are paid informally, making them less likely to report employment and earnings. In addition, over a third of domestic workers are immigrants, many of whom lack legal immigration status, and many fear the consequences of contact with the authorities, including participation in national surveys.

The lower pay level for domestic work reflects the racist and sexist structure of the US workforce, where people of colour, immigrants and women are paid less than average. A majority of domestic workers are Black, Hispanic, or Asian-American and Pacific Islander women. Over 40 per cent are older than 50.

According to the EPI: “The typical domestic worker is paid US$13.79 per hour, including overtime, tips, and commissions – 36.6 per cent less than the typical non-domestic worker, who is paid US$21.76. The typical domestic worker’s annual earnings are just two-fifths of a typical worker in another occupation.” As a result, “domestic workers are much more likely than other workers to be living in poverty,” the report concludes.

The human dimension of these statistics was described by Honor Nono, a Filipina domestic worker in San Francisco. “The work of a caregiver is no joke,” she told a 2016 rally supporting the Domestic Workers Bill of Rights. Nono spoke as a member of the Pilipino Association of Workers and Immigrants, originally set up by Filipinos for Affirmative Action. “Clients vary, they may be kind or unkind, happy or grouchy, difficult or easy, even dangerous. You can break your back, your neck, arms, or shoulder assisting your clients, transferring them from bed to wheelchair or vice versa. That is why we say the caregiving job is 3D: difficult, dirty and dangerous. Some caregivers do not get the minimum wage, workers compensation or paid overtime.”

Nono has been an organiser of other care givers. “We make all other work possible,” she told the rally, “and we work not only with our hands but with our hearts, because the people under our care also deserve love, respect and dignity. We are always in a battle, physically, and emotionally.”

Build Back Better

Passing a Domestic Worker Bill of Rights in California has been part of a national strategy, spearheaded by organisations including the National Domestic Workers Alliance and United Domestic Workers of America, to pass similar legislation elsewhere. To date, ten states and three cities have adopted it in some form, and they often include guarantees of paid time off, overtime, a requirement for written agreements and protection against discrimination. In California, the first bills originally proposed guarantees of eight hours of sleep for live-in workers, the right to use kitchen facilities to cook their meals, sick pay and vacations, cost-of-living raises and advance notice of terminations. The final Bill of Rights was more limited, but the original demands reflect a broad agenda of goals that domestic workers seek to win over time. In Seattle, for example, a more recent bill, passed last year, brings domestic workers under the state’s minimum wage law and qualifies them for unemployment insurance. A Domestic Workers Standards Board, with worker, employer and community representatives, will make further recommendations for improving working conditions.

When the Biden administration came into office in January 2021, many of these goals were incorporated into the Build Back Better bill, which included many elements of the various Bill of Rights. Other parts of Build Back Better would have made it possible for undocumented immigrants, including thousands of domestic workers, to gain legal immigration status. In negotiations with conservative Democrats, however, Build Back Better was pulled off the Democrats’ agenda, and only a bill funding infrastructure improvements was passed. That was a blow to domestic workers and immigrant rights advocates.

The inclusion of the domestic worker agenda in Build Back Better, and then the executive order in April, were the fruits of years fighting against their original exclusion from basic labour legislation.

“The Covid pandemic showed the urgency of the need and created a unique opportunity for making systemic reforms,” says Dell. “Making care available to all workers was included in Build Back Better. When it was knocked out and we could no longer pass those reforms, the executive order made sense.”

Nevertheless, it is difficult to quantify the concrete impact of the executive order, in terms of the number of people it enables to access care and the changes in the economic situation of care givers. “Basically, the administration was pulling every lever it could. In reality, there are only so many levers, so much they can do,” Dell says.

One major achievement of the statewide strategy was legislation in California that gave unions the right to bargain over wages paid to about 500,000 home care workers who provide care to people receiving support from the state’s In-Home Supportive Service Program. Two unions – the United Domestic Workers, a local affiliate of the American Federation of State, County and Municipal Workers, and Local 2015 of the Service Workers International Union – were then able to negotiate wages for workers on a county-by-county basis. That led to substantial raises, and a similar system was later achieved for childcare workers. Today UDW represents 98,000 workers, and Local 2015 represents about 450,000.

The effort continues to pass a national Domestic Workers Bill of Rights, although that path is effectively blocked without a change in the political balance of forces in the Congress. In addition, in 2014 the rightwing-dominated US Supreme Court held that home care workers couldn’t be required to pay union dues, and weren’t actually workers at all, but ‘caregivers’ who don’t come under labour law and can’t be considered state employees. In the meantime, state-by-state efforts are continuing. They make progress in states where domestic workers and care recipients are well-organised, and where progressive Democrats have legislative majorities and governors. “The state-based model has allowed us to organise at scale, but there are not enough states,” Dell warns.

The elections of 2024 could change that calculation, but whatever happens, Dell says that unions will keep fighting for decent work for care workers: “AFL-CIO wants to ensure that as we address the crisis of care in this country, we consider the needs of the workers who provide the care. At a time when we are considering making a historic investment in our care systems, we must make sure that workers are paid a living wage, with access to benefits, and the opportunity to join a union.”