We’re in the midst of a caregiving crisis. Here’s how Biden may address it

President-elect Biden’s $775 billion proposal to invest in the caregiving economy and expand access to childcare is projected to add 5 million new jobs.

We’re in the midst of a caregiving crisis. Here’s how Biden may address it
Daycare drop off, phase 4 reopening during Coronavirus Pandemic, Queens, New York. [Photo: Lindsey Nicholson/Education Images/Universal Images Group via Getty Images]

As the first wave of coronavirus outbreaks tore through nursing homes, caregivers were among the first to find themselves on the front lines of the pandemic. When state lockdowns closed schools and offices, countless working mothers had to juggle overseeing remote learning for their kids in addition to their full-time jobs—or were forced out of the workforce altogether. Childcare workers lost their jobs or risked exposure so they could continue going to work and taking care of the children of essential workers.


But this upheaval was far from unexpected. The pandemic and ensuing economic turmoil of 2020 merely exacerbated a caregiving and childcare crisis that many experts say was already on the verge of boiling over, even if it has often been given short shrift by politicians and the media. “I actually think we’ve been in a child care crisis for a long time,” economist Betsey Stevenson told Politico in July. “The pandemic has just pulled the lid off it, so we’re all staring at that crisis right now.”

Over the summer, against the backdrop of this unprecedented catalyst, then-candidate Joe Biden made the unusual decision to make caregiving a central piece of his platform: He introduced a $775 billion 10-year plan to improve care for children and the elderly alike and create better jobs for caregivers and childcare providers. “It’s the first time a man is leading an issue that’s so often associated [with] women’s work,” says Lelaine Bigelow, the managing director of external affairs at the National Partnership for Women & Families. “He speaks to it from his own lived experience.”

Often it’s female politicians who are more vocal about issues such as caregiving: During the Democratic primary, childcare was a centerpiece of Elizabeth Warren’s campaign. But the matter is personal for Biden, who was a single father to his two sons for years after his first wife passed away.

In terms of access to childcare, Biden’s plan proposes free pre-kindergarten for all kids ages three and four. Families with younger kids and a household income of under $125,000 would receive up to $16,000 in tax credits, or they could opt to take advantage of subsidized childcare that would be available to low-income and middle-class families.

The proposal also seeks to address the pandemic’s potentially lasting effects on the childcare industry, which is struggling to stay afloat in response to falling enrollment and has shed hundreds of thousands of jobs. A December survey of childcare providers by the National Association for the Education of Young Children found that more than half of respondents are losing money each day that they remain open, with 44% saying they’re not sure how much longer they can keep operating.

Now that Democrats have eked out control of the Senate, Biden stands a better chance of actually getting things done as president. But a 50-50 split, with Vice President-elect Kamala Harris serving as the tie-breaking vote, is hardly a comfortable majority, especially with the filibuster and a shrinking majority in the House. Parts of Biden’s caregiving agenda—tax credits for caregivers, for example—have some degree of bipartisan support, and Congress did manage to pass the Families First Coronavirus Response Act last year, which secured paid family leave for many workers. But the estimated costs of the proposal, as well as Biden’s plan to pay for it through tax increases, could hinder progress in Congress.


While the $900 billion stimulus bill that just passed earmarked $10 billion for childcare funding, advocates say that’s just a fraction of what the industry needs to survive this period, which is believed to be in the range of $50 billion. Biden’s plan calls for increasing pay and benefits for existing childcare workers and creating 1.5 million new jobs in the industry—good jobs that would secure affordable healthcare and paid family leave for a workforce that has historically been underpaid. Another proposal is to build more childcare centers and encourage businesses to invest in on-site childcare through a construction tax credit.

Whether we’re talking about caregivers or the parents who rely on them to stay in the labor force, this plan would overwhelmingly benefit women, and particularly women of color. Women account for 95% of the childcare workforce, according to the National Women’s Law Center. Women of color are overrepresented among domestic workers, accounting for a majority of home care workers. And during the pandemic, it is working women who have been most impacted as our already precarious caregiving infrastructure has been hobbled by the pandemic.

Working mothers who held essential jobs had to find alternate—and affordable—childcare arrangements, even as daycare centers struggled to keep their doors open, and many women who were working from home disproportionately bore the brunt of unpaid domestic labor. In September, 865,000 women dropped out of the labor force. Data released by the Bureau of Labor Statistics on Friday revealed that in December, women had accounted for all 140,000 net job losses; by year-end, a total of more than two million women had left the labor force.

“The pandemic has really shown that caregiving challenges are real and important and have an impact on women,” Bigelow says. “The lack of paid family leave and affordable childcare depresses economic mobility for women and especially women of color. They’re forced to stay at home or quit their jobs—and getting a good job is one of the best ways to improve a person’s economic standing. So the lack of these supports really hurts and continues to hurt women and women of color.”

It’s little surprise, then, that many voters are clamoring for a proposal like the one Biden has put forth. His team has projected the plan would augment overall employment by five million, by adding millions of new jobs in the caregiving sector and empowering other women to resume working or enter the labor force. In a recent poll conducted by the Service Employees International Union and the National Domestic Workers Alliance, 88% of respondents—more than 40% of whom were women of color—support Biden’s plan, as reported by The 19th. And while there’s been ample discussion of the childcare issues wrought by the pandemic, a major concern for many people surveyed was long-term care for the elderly.

In another survey, conducted by Time’s Up and Caring Across Generations, 70% of respondents were in favor of a comprehensive plan to support caregivers, through a coordinated set of reforms that could address everything from paid leave to funding for childcare and family care.


Some experts say even Biden’s plan doesn’t go far enough, and that it wouldn’t necessarily benefit the lowest-income Americans as much as it would others. Progressives might agree: Warren and Bernie Sanders, for example, had both proposed free universal childcare plans. In fact, Biden’s plan adapts many ideas that have already been championed by female politicians. Still, Biden’s holistic approach to caregiving—and framing those policies as economic issues—is unusual.

“What makes it so effective is that it’s focused on the lifespan of caregiving, from becoming a parent to caring for a parent,” Bigelow says. “It’s exciting that he put together a proposal that shuts down the argument for incrementalism. It shows that there’s an understanding from him about how intersectional and interconnected these issues are for families. You can’t just go all in on childcare and think you solved this problem.”

Aside from childcare, Biden’s plan would invest $450 billion toward improving care of the elderly and those with disabilities. The funding would allow families to opt for home-based care and help states get rid of the waitlist for home and community care under Medicaid, which currently has about 800,000 people. The proposal would also include hiring an additional 150,000 community health workers, along with expanding caregiving support for underserved communities, from veterans to Native Americans.

As with childcare workers, another priority is to increase pay and strengthen benefits for domestic workers and caregivers, who are often paid less than a living wage with few workplace protections to speak of. Biden’s plan also emphasizes the importance of worker organizing and unionizing, even pledging to sign into law the Domestic Workers Bill of Rights Act, which would enshrine basic workplace rights for nannies and home care workers.

If the stimulus negotiations are any indication, it’s hard to imagine that Biden’s current plan will pass muster in Congress, even with a Democratic majority. But even if what ultimately passes is a hard-won, piecemeal version of Biden’s proposal, Bigelow is hopeful that caregiving reforms appear to be core to his pandemic response and economic recovery, rather than an afterthought.

“I really do have a lot of optimism about [this] year and where we can take these issues,” she says. “It is very obvious that these issues are not a nice-to-have but a must-have.”

About the author

Pavithra Mohan is a staff writer for Fast Company.