Charles Krupa/AP Photo
A Massachusetts family enjoys a warmer-than-usual December day on a grassy field at the Quabbin Reservoir in the town of Ware, 2015.
The issue of paid family leave finally got the attention it deserved in the penultimate Democratic presidential primary debate of 2019. Andrew Yang reminded viewers that U.S. and Papua New Guinea are the only countries without paid parental leave laws and offered his familiar panacea for this and every other social problem: a universal basic income of $1,000 a month for every adult—yet child care costs alone would consume most of that sum. Several candidates, including Amy Klobuchar and Kamala Harris, have endorsed the Family and Medical Insurance Leave (FAMILY) Act, a plan introduced by Kirsten Gillibrand, who dropped out of the presidential contest in late August. Klobuchar put forward three months of leave (as the FAMILY Act does), which she admitted is modest but financially feasible. Harris had the most generous proposal with six months of paid leave, though she didn’t say how she’d fund it.
“These families and parents are often raising young children and taking care of their parents, which requires a lot of work,” Harris said. “So six months paid family leave is meant to and is designed to adjust to the reality of women’s lives today.”
Given the ballooning costs of caregiving, it’s surprising that the need for a comprehensive family care plan hasn’t received more national attention. Looking after a loved one, like a newborn or an ill parent, can cause great financial strain. A typical family in California spends about a quarter of its annual income on infant care, which is slightly higher than in-state tuition at a public college or university. The number of Americans over the age of 65 is projected to double in the next 40 years—which will force families to grapple with adult caregiving issues like the serious shortage of in-home health aides, who experience high turnover rates and increasingly live in poverty.
So far, Elizabeth Warren is the only Democratic presidential candidate to have introduced one component of such a plan: universal child care. Funded by her proposed wealth tax, it would cost the federal government an additional $70 billion a year. Her proposal, however, does not address paid leave or senior care.
Yet implementing a state-based program that gives individuals and families the financial security they need to tend to relatives should not be a Herculean feat. In June, the National Academy of Social Insurance (NASI) proposed “Universal Family Care,” a model program that states can study and adapt to address the three most costly areas of care: early child care, paid family leave, and long-term services and supports (LTSS) designed for, but not limited to, seniors. The report also lays out two possible funding strategies that states could deploy: relying on general tax revenues or establishing a payroll tax.
At a recent Economic Policy Institute (EPI) forum, the program’s architects explained that Universal Family Care will not require states to build expensive, new social services infrastructure. Instead, they’ll just have to tweak and combine existing programs. “We’ve had paid family leave since around 2000. We know how to do social insurance for LTSS,” said Benjamin Veghte, research director at Caring Across Generations, a Washington-based family care advocacy group. “Affordable child care is the only missing piece.”
Currently, most states address these issues piecemeal rather than through a coordinated strategy to tackle all three areas. In May, Washington became the first state to create a social insurance program for long-term services, offering up to $36,500 in benefits for an individual worker (but not family members) who needs help with daily activities, such as eating or bathing. The plan will be funded with a payroll tax, but not everyone qualifies: A worker must be over the age of 18 and must have paid the levy for five consecutive years before he or she can take advantage of the program.
Five states, including California and New Jersey, have implemented programs that only cover paid family leave. Earlier this year, New Jersey expanded its program, doubling the paid benefits period from 6 to 12 weeks. But similar paid family leave measures in Maine and Maryland faltered.
The price tag for any social insurance program is a hard sell. An early child care and education system in California would cost somewhere between $30 billion and $75 billion, or roughly $30,000 per child, according to an EPI study. And Medicare and Social Security costs are rising as well.
A program like Universal Family Care would cost workers an additional $80 per month in taxes, and reframing the cost-benefit analysis of these plans may be the key to passing them, said Alexandra Bradley, the lead policy analyst on the NASI study. “When you boil it down, it’s the cost of one coffee a week,” she said. “That’s for six weeks of paid time off for child care.” Since legislators deal with constituents who have different political ideologies and economic backgrounds, she continued, it’s more effective to compare the costs for an expanded family care program to everyday expenditures. “When you look at the true individual-level costs, people are not so sticker-shocked anymore,” she said.
Meanwhile, Elise Gould, a senior economist at EPI who has studied California’s child care system, said that the strength of Warren’s proposal lies in its scope. By lifting the financial burden of child-rearing, the plan would grant parents—mothers, especially—greater spending power and allow them to work longer hours, thereby boosting economic growth and offsetting the cost of implementation. “Warren has acknowledged that it’s not just about affordability for families,” Gould said. “It’s also about the care workforce across the spectrum.”
