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A Society That Cares

The United States is alone in the developed world in its failure to cover healthcare for its residents, mandate paid parental leave, and adequately subsidize the cost of child and long-term elder care.

The fastest growing section of the country’s workforce, home health care aides, are among the poorest paying and most insecure jobs in the country.

As the father of a young child, and a freelancer who has struggled with mounting healthcare costs, Nikil knows the squeeze that the current system places on working people, and the staggering amount of debt that people are forced to shoulder just to make ends meet.

A dynamic and innovative society is one that cares. We need to plan for an aging society, to make childcare affordable, and guarantee healthcare for everyone.

Healthcare for all.

The United States can afford, and Americans deserve, a single-payer healthcare system on a federal level. Creating this system will require coordination with states, and Pennsylvania should create its own single-payer system to allow this coordination. We should also take steps to protect existing Medicaid coverage to support access to health coverage for all Pennsylvanians.

Nikil supports:

Creating a single-payer healthcare program in Pennsylvania. Existing single-payer bills in PA ought to be expanded to cover all residents, regardless of immigration status, and ensure that abortion rights, all forms of disability, physical and psychotherapy, and the needs of queer, non-binary, and trans patients are fully supported and met by the system.

Immediately expanding eligibility for Medicaid and CHIP. We should protect and expand existing Medicaid coverage and prevent work requirements and other barriers for Medicaid, so that no one goes without needed healthcare services or is forced to go into debt.

Paid Care Leave

Pennsylvania should provide income support for all workers who need time off to take care of a loved one. All adults experience moments of increased caregiving obligations, such as the birth of a new child, or a partner falls sick, that interfere with full-time work. All workers should be able to attend to those care needs without fear of risking poverty.

The current federal legislation provides unpaid job protection for 12 weeks, but it lacks income protection, severely constraining the ability of many workers to adequately meet the care needs they have. The ability of workers to care for their loved ones improves the wellbeing of children, adults, and older adults, providing immediate benefits for those involved and long-term benefits for society at large (including companies). We have the collective responsibility to support caregiving.


Nikil supports:

Establishing a paid care leave plan in Pennsylvania. This plan should guarantee 100% of earnings for all workers making 70% or less of the state average weekly wage (SAWW). The plan would be funded principally on employer contributions, either based on the size of the firm or the firm’s profitability (in the case of small firms with high earnings). For those making more than 70%, workers should get 70% of the SAWW, and 60% of the earned income that is above 70%.

Mandating at least 12 weeks of paid leave for all care events. The paid care leave plan should be guarantee a minimum of 12 weeks of paid leave, with eligibility guaranteed by anyone who pays partially into the fund (direct employees or independent contractors). Needs include: birth, adoption, surgery, illness of kin.

Long-Term Care

Pennsylvania’s population is aging, as older adults represent an increasing share of the total population. While some individuals require nursing home or other institutional services, nursing homes can be costly for families, and the majority of Americans prefer to remain at home if they are able. Currently, family and friends often serve informally as unpaid caregivers. Many unpaid caregivers do so while also working, creating challenges for those who have to balance the demands of their jobs with the needs of their loved ones. The paid caregiver workforce experiences low wages and inconsistent schedules, and nearly half live in low income households. The need to support skilled, available, stable caregivers to provide long-term care services is clear

Despite the increasing need for caregivers to support older adults, people with disabilities, and their families, existing policies to support individuals and their families and caregivers fall short. Coverage for long term care services through Medicaid and Medicare is limited. Although privately purchased long term care insurance is available, the high costs are prohibitive for many, and few older Americans purchase extra private insurance. The gaps in long term care coverage leave many families scrambling to figure out how to provide care for loved ones when caregiving needs arise.

Nikil supports:

The adoption of universal long term care coverage for Pennsylvanians that is
available for any individual or family regardless of income to access benefits to meet long term care needs. The coverage covers home and community based services. Longterm care could be funded either through the establishment of a long-term care benefits fund, or establishing the program as a new eligibility group within Medical Assistance (Pennsylvania’s Medicaid program).

Living wages and opportunities for workforce development. Caregivers are the
fastest growing section of the heath care workforce, and provide essential services to support health at home.

The adoption of a statewide Domestic Workers’ Bill of Rights. This bill would be
modeled on Philadelphia’s Domestic Workers’ Bill of Rights, which guarantees rest and meal breaks, paid time off, civil rights protections and written contracts for nearly all domestic workers.


Pennsylvania offers only meager subsidies for childcare, and Philadelphia offers a limited subsidized pre-K program. The lack of subsidized childcare makes it hard on workers seeking a return to work, and also makes it difficult to guarantee caregivers a living wage. Early childhood education is also a critical factor in the growth and health of children long-term. A caring society should seek to make childcare affordable and eventually free.

Nikil supports:

The creation of a comprehensive universal early child care and education social insurance program for Pennsylvania. Child care would be universally available from 12 weeks of age, regardless of parent or guardian employment status, with private childcare solutions and home-care solutions supported through public subsidy.

Ish Saval for All
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