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This week, President Joe Biden signed an executive order on caregiving, which may sound like Washingtonspeak. It isn’t. It’s entirely possible that the order could make a real difference in the real lives of some real Americans.
But it’s still just executive action, which means there are limits to its potential. In that sense, the executive order is also a case study in the need for much more ambitious action ― action that will take a lot of work on politics and maybe some work on policy as well.
The order is basically an instruction to federal agencies to figure out ways of making child care and care for the elderly and people with disabilities more affordable, accessible and reliable ― all while helping out the caregivers themselves.
The need for that kind of action is clear enough, or at least it should be.
Just this week, data analyst Jeremy Ney published an article showing that millions of Americans are paying a quarter of their incomes on outside child care, according to newly released Labor Department data. As Ney notes, that burden is especially crushing for low-income Americans who simply don’t have a quarter of their income left after paying for housing, food and other necessities.
And then there are the parents who aren’t worried about the cost of child care — because they can’t find any.
Some child care centers closed during the pandemic. Those that didn’t or reopened are having trouble filling staff openings because of the tight labor market ― and the fact that if you’re looking for work, you might make more manning a register at Target than you can feeding, nurturing and watching over toddlers.
The child care workforce is still about 60,000 short of where it was before the pandemic, according to the U.S. Labor Department. In a recent article from The 19th featuring reader emails about struggles to find child care, some described waiting lists for slots that measured in years, not months, with one saying they knew of a child care worker who gave out waiting list spots as wedding gifts. (Yes, wedding gifts ― not baby shower gifts.)
The labor scarcity extends to the workforce that staffs nursing homes and other forms of assisted living, as well as the workforce that goes into people’s homes to assist them there, which is what most seniors and people with disabilities would prefer. In the face of these shortages, some of the people who need care end up going without help at risk to their health or well-being, while others end up in the large-scale facilities they’re desperate to avoid.
Policymakers know all about this. Biden and his Democratic allies spent much of 2021 and 2022 trying to enact a set of sweeping, potentially groundbreaking initiatives to make both child care and home care more affordable and more reliable. It was supposed to be part of what they were calling the “Build Back Better” plan.
But the initiatives were expensive, each one requiring several hundred billion dollars of new expenditures in the first decade, and they fell out of the final legislation ― later renamed the “Inflation Reduction Act” ― at the insistence of Sen. Joe Manchin (D-W.Va.) and a handful of other lawmakers who opposed so much new spending. (HuffPost covered that history here, if you need a refresher.)
Biden and the Democrats say they haven’t given up trying to enact new reforms on that scale. But with a Republican House pushing for massive cuts in federal spending ― and holding the nation’s economic well-being hostage in an attempt to get its way ― the prospects for enacting such a program in this Congress are virtually nil.
That explains the executive order, which represents Biden’s attempt to make a downpayment on a much larger effort.
What’s In The Executive Order – And What Isn’t
The order instructs the government to consider 50 initiatives, including one designed to raise the salaries for instructors in Head Start and another that would reduce what families pay out of their own pockets when they use federally subsidized child care.
Other initiatives would raise pay for home care workers and provide short-term assistance to family caregivers (that is, people caring for their own family members) by tweaking rules and payments that go through Medicare and Medicaid. Still another would require federal contractors to provide child care to their own workers, which is more or less what the federal government is already doing with its new microchip manufacturing initiative.
To be clear, these are just orders to agencies to investigate these possibilities and then make recommendations based on what seems feasible.
There’s no guarantee any of these initiatives will actually happen or what they will look like, especially because most of them require changes in the flow of money. And while that means somebody (say, home care workers) could get more money, it could also mean somebody else (say, home care agencies) could get less. Whoever stands to get less is sure to make a lot of political noise about it.
Even if political opposition doesn’t limit these initiatives, resources will. Federal agencies can’t create programs and they can’t appropriate new money. They have to use the authority and money they already possess. To put it another way, the most ambitious version of these initiatives isn’t going to be that ambitious ― or anywhere close to meeting the needs out there.
So what will it take to do more?
The challenge is in many ways a political one ― and, more specifically, an electoral one. The care provisions of Build Back Better didn’t become law for the very simple reason that they came up a few votes short in the Senate. Give Democrats control of the House again, then give Senate Democrats two more members like longtime caregiving champions Bob Casey of Pennsylvania and Patty Murray of Washington, and there will probably be the votes for something big.
What A Serious Initiative Would Look Like
But then there is the question of what “big” should look like.
The policies in Build Back Better were the product of years of internal debate among officials, advocates and experts. They represented an attempt to fit legislation to tight political constraints. And as always, that meant lots of messy compromises, like counting on potentially reluctant states to take the money and implement the programs.
Precisely because major legislative action isn’t likely at least until the next election, and maybe beyond, this is probably a good time to scrutinize those plans ― and maybe even step back to ask what exactly these programs are trying to do.
Especially with child care, lawmakers and advocates talk about pursuing multiple goals, some of which are in tension with one another or other policy imperatives, as Rachel M. Cohen noted in a perceptive Vox article this week. The surest way to improve the quality and stability of child care programs, for example, is to pay workers more. But that makes child care more expensive, making the affordability problem worse. Some parents would prefer to care for children on their own, but subsidizing them directly runs smack into popular discomfort over “welfare” and its effects on work incentives.
It’s possible to find policies that balance the tradeoffs, which is what the Build Back Better architects were trying to do. Maybe there’s a better set of compromises out there; maybe there isn’t. The only way to find out is to ask those big questions and to smoke out who in Congress is willing to vote for what before the next round of serious legislating begins.
Until then, there’s always executive action like the kind Biden just rolled out, which isn’t even close to everything the country needs but is still a lot more than nothing. It’s the policy equivalent of baby steps. But as every child care provider ― and every parent ― knows, those baby steps are what lead to walking and then running in the future.