Sept. 20, 2021
American families are being squeezed by stagnant wages and the rising costs of care for children, older adults and others in need. Even before the pandemic, 40% of families could not afford to cover a 400 dollar emergency expense. Millions of families struggle to balance competing work, household, and caregiving responsibilities.
Policymakers typically address child care and long-term care needs as separate matters , while families experience them as part of the same challenge: the inability to manage and afford receiving or providing quality care. More than 3.5 million children are born each year, most into families where all adults work. This transformation in society has not been met with commensurate policies to support families. Many parents - particularly lower-wage workers - do not have paid parental leave to care for children in the first weeks and months of their lives; child care is expensive and often difficult to find. An estimated 8.2 million of these parents also care for an older adult. 75 percent are working full-time or part-time jobs.
The number of working people with family care responsibilities will only grow as our population ages. By 2060, 94.7 million Americans will be 65 or older, while the number of working-age adults available to care for an older loved one steadily shrinks. Just 2.9 working age adults are projected to be able to provide care for each older adult by 2050, down from a 7:1 ratio in 2010.
Some private companies are attempting to fill the gap by increasing wages, offering paid family and medical leave benefits, and providing access to child care and elder care, but these benefits are most often reserved for high-wage professional workers and, even then, only reach a fraction of employees and households. Inadequate access to care perpetuates disparities in income, health, education and more. The United States is long overdue in making the investments our families need to thrive. A comprehensive policy approach to invest in care would especially benefit women, working families, and families of color, who have shouldered the cost of policy inaction for too long.
It will take more than a single policy or intervention to make a difference in the lives of millions. It will take substantial new investments in addressing the full lifespan of care needs in a comprehensive, sustained and inclusive way. It will take recognizing that at some point or at multiple points, everyone will need to provide, receive or find care.
The Biden-Harris Build Back Better plan and the Build Back Better Act that Congress is writing include the types of investments in policies the country needs:
- a historic, comprehensive paid family and medical leave program
- policies to increase access and reduce the costs of child care while raising the wages of child care providers,
- an extension of an expanded child tax credit to help families support the rising costs of living, and
- investments to increase access to home and community-based services for older and disabled people and higher wages for paid caregivers of this long-term care.
These investments in care infrastructure and family pocketbooks don’t only support families; they are deeply connected to the success of our economy overall. Better policies will help create millions of jobs, produce billions of dollars in higher wages and support household economic security while adding trillions to U.S. GDP as more women, caregivers and people of color are able to participate more fully in the paid workforce. It’s also time we made investments in the 43 million caregiving professionals that we rely on who are often paid too little. In the U.S. the economic contribution of these workers has been valued at $470 billion.
Build Back Better Bill Makes Across the Board Investments in Our Families -- Child Care, Paid Leave, Child Tax Credits and Long-term Care -- at Once
We can’t afford to invest in only one policy; we need to invest across the care landscape to ensure reliable access. Doing so raises quality of life, and supports our overall health and wellbeing.
Quality, affordable care allows those who want to work to stay in the labor force. If American families had access to the care they need, they would earn an additional $28.9 billion a year in wages that they currently forgo due to caregiving responsibilities. Improving access to care would bring at least 5 million more women into the labor market, and provide families with greater agency in how they live their lives.
Investing in care also benefits the essential workers who provide care. More than half of childcare workers rely on public assistance to get by, and 4 in 5 child care centers remain understaffed. Eighteen percent of home care workers live in poverty, despite the fact that this is one of the fastest growing professions in America.
Addressing these disparities will also allow us to grapple with a source of inequity in our workforce: sixty-six percent of Black and Latinx caregivers said that family caregiving responsibilities impacted their ability to work, ten percentage points higher than white caregivers. Investments in care infrastructure are necessary to address structural disadvantages that Black and Brown women face in accessing quality jobs.
Additionally, there is too little consideration in policy conversations about the exorbitant bills for long-term care many Americans face as they age. Total costs for home care for older adults amounts to more than $90,000 for men and $180,000 for women or 150% percent of median household annual income.
The status quo isn’t serving families or workers, which is why we need bold new investments outlined in the Build Back Better package to ensure a more inclusive recovery. These investments would support each of us and our loved ones across our lifetimes.
- Child Care. Universal pre-k and an expanded childcare credit would help families find the care they need.
- Paid family and medical leave. Provide 12 weeks of paid leave for serious health and care needs to all working people who need it, including independent contractors, part-time and contingent workers.
- Child Tax Credit (CTC). Permanently expanding the CTC will cut child poverty in half.
- Long-term care (Home and Community-Based Services). Investing in long-term care (HCBS) programs will make sure seniors get the help they need, while supporting workers. An additional 3.2 million will have access to care, while this policy will support 1.1 million new jobs.
The New Practice Lab works to improve the design and delivery of policies focused on family economic security and wellbeing through direct knowledge of, or input from, the families they are meant to serve. Through our discovery sprint process, we bring user researchers, designers, technologists, data scientists and other experts together with government and non-profit partners to improve the implementation of income supports (such as the earned income tax credit and child tax credit), public benefits (such as unemployment insurance) and care infrastructure (such as paid leave, early and long-term care) for families.