Biden to Sign Executive Order Aimed at Reducing Cost of Child Care and Long-Term Care

President Joe Biden speaks during a joint news conference with Canadian Prime Minister Justin Trudeau, in Ottawa, Canada, on March 24, 2023. Reuters/Blair Gable/File Photo

President Joe Biden announced an executive order in the Rose Garden on April 18 designed to increase access to and lower the costs of long-term care and child care, and support care workers and family caregivers the White House said in a statement.

Calling it the most “comprehensive set of executive actions any president has ever taken to improve care,” the White House reported in a fact sheet that the order includes more than 50 directives across almost every Cabinet-level agency.

The cost of child care is “up 26 percent in the last decade and more than 200 percent over the past 30 years” and costs for the elderly or people with disabilities have increased 40 percent over the last decade, the fact sheet said.

“The result is many Americans—particularly women—stay out of the workforce to care for their families, making it hard for businesses to attract and retain a skilled workforce and for the economy to grow,” the fact sheet said.

Children wave their hands at a private nursery school. Christopher Furlong/Getty Images

A Boston Consulting Group study shows that the Gross Domestic Product will lose $290 billion each year in 2030 and beyond if the United States does not improve the lack of affordable childcare, the according to the fact sheet.

“At the same time, many workers providing this critical care find themselves in low-paying jobs with few benefits. Care workers, who are disproportionately women of color, struggle to make ends meet, and turnover rates are high,” the White House said. “In addition, at least 53 million Americans serve as family caregivers—including over 5 million caring for service members or veterans—and many face challenges due to lack of support, training, and opportunities for rest.”

Move to Make Childcare More Affordable

The Biden administration “called for investments to support high-quality, affordable child care, preschool, and long-term care in their fiscal year 2024 budget,” the White House noted.

“While Congress considers those proposals, the president is taking immediate action to make care more affordable for American families, support family caregivers, boost compensation and improve job quality for care workers, and expand care options,” the fact sheet added.

The fact sheet reported that the White House is urging federal agencies to “identify which of their grant programs can support child care and long-term care for individuals working on federal projects, and consider requiring applicants seeking federal job-creating funds to expand access to care for their workers.”

The order would also direct the Department of Defense to initiate steps to enhance the affordability of childcare on military installations.

Under the order, the Office of Personnel Management is tasked to “conduct a review of child care subsidy policy and consider setting standards for when and how federal agencies should provide child care subsidies to federal employees.”

Federal agencies will review opportunities to “expand employee access to childcare services through federal childcare centers, childcare subsidies, or contracted care for providers,” according to the order.

Biden plans to expand requirements incorporated in the CHIPS and Science Act earlier in 2023, mandating that manufacturers offer employees childcare to qualify for subsidies of $150 million and above.

The Department of Health and Human Services (HHS) will be asked to determine how to lower or eliminate costs for families under the Child Care & Development Block Grant (CCDBG), a program that helps subsidize care for low-income families.

In the budget passed at the end of 2022, the CCDBG received a 30 percent increase in funding.

President Joe Biden delivers remarks before signing nine bills into law with the goal of improving military veterans' lives in the State Dining Room at the White House on June 7, 2022. Win McNamee/Getty Images

Proposed Helps for Veterans

Biden is asking the Department of Veterans Affairs to expand the Veteran Directed Care program, which allows veterans to hire health aides to receive care in their own homes, rather than in more institutional facilities like nursing homes.

Through the program, veterans can select their own care staff instead of an agency choosing staff for them. The program also allows family caregivers to potentially receive pay for their work if the veteran hires them.

Other provisions target supporting the nation’s 43.5 million caregivers, including a recommendation encouraging HHS to test a new dementia care model that includes respite care for family caregivers of people with dementia.

Usually provided by an agency, respite care is short-term care to allow family caregivers the time they need to rest and recharge.

The Biden administration is also requesting that HHS streamline the process that involves applying for childcare assistance to build or improve childcare facilities on tribal lands.

The White House said that an estimated 500,000 American Indian and Alaska Native children under the age of 5 need access to childcare.

Increasing Pay for Childcare Workers

Chronically low pay for childcare workers is at the center of the childcare crisis.

“Early care and education professionals are among the lowest-paid workers in the country,“ the fact sheet detailed. ”Child care workers earn a median wage of less than $18 an hour, while the typical nonsupervisory worker in the U.S. earns over $28 an hour. While the average salary of a public preschool teacher and kindergarten teacher is about $49,000 and $60,000, respectively, the average annual salary for Head Start and preschool teachers is about $35,000.”

Biden will address this by taking steps to increase the pay and benefits for Head Start teachers and staff. Restructuring how providers are reimbursed with federal funds is one step to accomplishing that goal, the White House official noted.

The Biden administration invested over $60 billion from the American Rescue Plan (ARP) Act in the care economy, including $39 billion to help child care providers keep their doors open and to provide child care workers with higher pay, bonuses, and other benefits—reducing turnover and attracting new staff,” the White House said.

These efforts “have helped 220,000 childcare centers which employ more than one million childcare workers with the capacity to serve 9.6 million children,” the fact sheet highlighted.

The Biden administration has also “invested $25 billion in ARP funds to help states strengthen their Medicaid home care programs, including over $9 billion in spending to boost wages for home care workers as well as improve overall job quality,” the fact sheet continued.

In 2021, Biden’s $1.7 trillion “Build Back Better Act” included investments in child care and pre-kindergarten along with four-week universal paid leave, but the measure did not get through Congress.

The Biden administration has explored ways since then to address access to and costs of care.

‘Looking Under Every Rock’

During a call with reporters on April 17, a White House official said that the administration is “looking under every rock” and using every tool at its disposal.

Orders can only direct agencies to consider making improvements in different areas, but they deliver a strong statement about where Biden expects them to improve, the White House official added.

Getting increased funding for childcare and long-term care programs will be challenging in a divided Congress, the White House official admitted.

“This is a case where the president is working hard on the investment angle and has worked hard with Congress, but that avenue has not worked out as well,” the official said on April 17.

Through the order, Biden would like to see investments on the scale of what the president is proposing in his fiscal year 2024 budget, which is $600 billion over 10 years for child care and $150 billion to improve and expand access to Medicaid home services in that time frame, a White House official said.

Until then, the official noted that “we’re going to do everything we can to increase access to care and support care workers and family caregivers.”