DES MOINES, Iowa -- Providing care for a loved one comes with a lot of stress. A new report said there's financial pressure too, especially when it comes to out-of-pocket expenses, and Iowa families are feeling that pinch.

Research from AARP showed nearly eight in ten of those caring for an adult family member face regular out-of-pocket expenses. Annual average spending accounts for 26% of the caregiver's income.

Dorothy Pisarski of West Des Moines said it is something her family experienced when her husband had a stroke more than a decade ago.

"It's just like a tornado in your house where everything gets swept up because of this," Pisarski explained. "It's time, it's money, it's stress."

Her husband's disability resulted in a significant loss of income, which left Pisarski to manage typical expenses, along with things like transportation to her husband's appointments, on a leaner budget.

There are an estimated 300,000 family caregivers in Iowa. Their advocates want Congress to approve a bill that offers tax credits of up to $5,000 to those eligible. The plan has bipartisan support, but some observers noted it excludes retired individuals providing care.

Brad Anderson, state director for AARP Iowa, said there needs to be a sense of urgency for Congress to act, and noted working caregivers are reaching a breaking point.

"Caregiving as we know is oftentimes considered a part-time job, and so you have people working two jobs essentially, but one of the jobs they're not getting paid for. And those folks need help," Anderson argued.

Pisarski also called on health-care providers to offer more affordable options for medication, and to speed up communication on rehabilitation recommendations. She asserted it would have eased the burden in the immediate aftermath of her husband's stroke.

"Even in visits, in short moments, that would have been helpful in making good use of time to help in his progress," Pisarski remarked.

Meanwhile, the report said the highest expense burden falls on younger caregivers and those who are African American, as well as Latino caregivers. Iowa's Joni Ernst is the lead sponsor of the Senate bill.

Coaches in the Renton School District, just south of Seattle, are organizing with the American Federation of Teachers to fight for what they say are "fair wages" in their first union contract.

Buddy Ryan, head boys track and field coach at Hazen High School, said Renton coaches get paid much less compared with neighboring school districts, which contributes to a 45% turnover rate in coaches from year to year.

"I'm not expecting to go buy a new car off a season of coaching, but I'm not expecting to make minimum wage to be responsible for all these kids," he said. "I think the reality is, a fair wage for a fair day's work is what everybody looks for."

Renton School District has proposed a 2.5% wage increase, far below what the coaches asked for. AFT has said the district has the funds to pay coaches fairly. The district did not respond to a request for comment.

Ryan said the low pay and high turnover rate costs the district more money in training and degrades the quality of the sports programs.

"And then what's the cost to the kids that get a different coach every year? Well, you know what ends up happening? These parents get tired of it and they take their kids to private schools, or they move and transfer them to other schools," he said.

Ryan noted that sports, along with other extracurriculars such as band, are what motivate many kids to keep their grades up in order to participate. He said the district should want to keep the programs strong.

"It's just like when you're a kid at dinner," he said, "and your parents say, 'You've got to eat your vegetables or you don't get dessert.' Well, that dessert is the after-school activities."

Nevada groups concerned about affordability, clean air and health care are speaking out against the "One Big Beautiful Bill Act" recently signed by President Donald Trump.

The new law extends tax cuts from 2017, funded partially by huge cuts to Medicaid and SNAP food benefits.

Dr. Joanne Leovy, steering committee chair for the Nevada Clinicians for Climate Action, noted it also ends the tax credit for electric vehicles on Sept. 30, which drives up the price of an EV by $7,500 while promoting the sales of gas-powered vehicles.

"This bill will dump an extra 2.1 billion tons of climate pollution into the atmosphere over the next decade," Leovy pointed out. "Increasing greenhouse gas emissions by about 7% over prior projections; the equivalent of adding more than 400,000 cars to the road."

The new law also cuts tax credits for rooftop solar and energy efficient home upgrades. Backers said the savings were necessary to fund other administration priorities, such as increased funding for immigration enforcement.

Yolanda Kemp, a member of the American Federation of State, County and Municipal Employees Local 4041, said she worries about job losses in the public sector.

"When states, cities, towns, and schools lose essential federal funding, they will be forced to make cuts to their budgets as well, putting all public services and jobs at risk of being cut," Kemp stressed. "And let me tell you, the 'Big, Beautiful Bill' that is supposed to help hardworking Americans is nothing more than another billionaire giveaway paid for by us."

The change to Medicaid and SNAP are not immediate but will be phased in mostly in 2027 and 2028.


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More than 1,100 caregivers at Portland's Providence St. Vincent Medical Center have voted to unionize, joining the Service Employees International Union Local 49.

Hospital staffers, including certified nursing assistants, cooks, lab assistants, pharmacy techs, environmental workers and patient representatives, will soon begin collective bargaining with management over a new work contract.

Finn McCool, senior food service attendant at Providence St. Vincent Medical Center in Portland, said changes to working conditions in the hospital were a major driver to organize.

"There's a lot that makes St. Vincent a great place to work, but we've also seen just tons of changes over the years around staffing and benefits," McCool explained. "My fellow caregivers really knew that jobs were only going to get harder."

The St. Vincent caregivers will join thousands of other unionized workers at Providence hospitals in Oregon, Washington state and other parts of the country. Providence officials released a statement, recognizing the union and saying they were prepared to work with it toward a new contract.

McCool noted the company made several changes to staffing and work policies without feedback from its employees, with changes to the employees' health care benefits causing a major upheaval.

"It's been a recent change to our health care plan with Aetna switching over, and that was probably a very large reason why a lot of us decided to vote yes," McCool pointed out. "We had our own internal health care system. We changed to a different thing. Co-pays changed. Things were definitely a lot harder with increased deductibles."

McCool stressed political uncertainty, particularly in the government's health care policies, was also a significant concern.

"We're seeing a lot of changes going on with the government with cuts, especially right now," McCool observed. "What threatens us is cuts to Medicare and Medicaid. Our CEO said, 'These cuts are threatening the hospital.'"