For millions of Americans, caring for a loved one is essential work — yet it comes with a hidden price tag that doesn't show up until retirement. Social Security, the bedrock of retirement income, only counts paid employment, leaving an estimated 49.5 billion hours of unpaid caregiving invisible to the system each year, according to AARP.
More than 59 million Americans provide unpaid care to family, friends, or neighbors annually, contributing labor valued at roughly $1.01 trillion — more than all federal, state, and local Medicaid spending combined. Despite this massive contribution, many caregivers retire with drastically reduced benefits, never seeing their caregiving years reflected in their Social Security earnings record.
In many cases, these caregivers are propping up the long-term care system itself. Medicaid, the nation's primary payer for long-term services, typically only steps in after families have exhausted their own time and savings. By keeping loved ones at home, informal caregivers delay or prevent costly institutional placements, saving public dollars. Yet their work goes unrecognized, and the financial consequences fall squarely on them.
The burden is not evenly distributed. Women — especially women of color — provide the majority of care, live longer on average, and retire with fewer resources. Black and Hispanic families, already facing generational wealth gaps, are more likely to take on intensive caregiving with fewer financial protections, compounding retirement insecurity. As lawmakers like Florida Democrat Frederica Wilson have highlighted, retirement security is a pressing issue for millions.
Liz Smith, a longtime unpaid caregiver and social work expert, knows this firsthand. Over 20 years of caregiving, she pieced together service-industry jobs and accumulated just $8,000 in savings. “Retirement planning was often seen as a rich person’s problem,” she said.
The proposed solution: caregiver credits within Social Security. Currently, workers need at least 40 quarters (about 10 years) of paid employment to qualify for benefits, which are based on their highest-earning years. Caregiving often leads to employment gaps, delayed careers, early exits, and unstable schedules, making it hard to meet that threshold. Caregiver credits would count caregiving years toward benefits, using a formula based on prior earnings or average wages — similar to models used in other countries.
In 2024 alone, unpaid caregiving hours were equivalent to 23.8 million full-time workers. That scale of responsibility makes it unsurprising that so many caregivers fall short of the 40 quarters needed for eligibility. Credits would expand eligibility and increase average benefits, potentially reducing reliance on means-tested programs like Medicaid, Supplemental Security Income, and SNAP. As savings rates plunge and energy costs outpace wages, the need for such reforms grows more urgent.
“We are already paying for the consequences of unpaid and uncredited caregiving, just at the wrong point in time,” Smith said. When caregivers reduce hours, drain savings, or leave the workforce, the financial impact doesn't vanish — it shows up later in retirement, forcing heavier reliance on public assistance. By recognizing caregiving earlier through Social Security credits, the U.S. could shift some of that spending upstream, reducing long-term costs while strengthening financial stability.
The question is no longer whether we can afford to credit caregiving — it's whether we can afford not to.
