Biden Signs EO Expanding Access to Child and Long-Term Care

WASHINGTON — President Joe Biden on Tuesday signed an executive order during a Rose Garden ceremony dramatically expanding access to child care and long-term care for the elderly and others that need it.

“We’re here today to take action on an issue that’s fundamental to who we are as a nation,” the president said before an audience that included scores of family and child care advocates and care providers.

“How we treat the people we care about and who need the most help, our children, the people we love, people with disabilities, veterans … and the value we place on nurses, child care workers, home care workers and family caregivers, [defines] who we are as a country,” Biden said. 

He called the executive order, which issued more than 50 directives to nearly every Cabinet-level agency, “the most comprehensive set of actions any administration has taken to date to increase access to high-quality child care and long-term care and support for caregivers.”

He also said that despite its sweeping nature, the executive order “doesn’t require any new spending” and that it will ensure “taxpayers will get the best value for the investments they’ve already made.”

The signing of the order fulfills a vow Biden made in his State of the Union address and comes ahead of his anticipated announcement that he will seek reelection in 2024.

During his remarks Biden recalled his own experience as a single parent of two young children after his wife, Neilia, and one-year-old daughter, Naomi, were killed in a December 1972 car accident.

“Thank God, I had a large family to rely on,” he said.

“My sister, my brother, my brother-in-law, my mother, they all chipped in,” the president recalled. “My sister and her husband gave up their home and moved into where I lived just to be there to help me with my kids. Folks, you know, I couldn’t have done it without their help. I couldn’t have made it. 

“I often ask myself what in God’s name would I have done — not a joke — had I not had the family I had?” Biden continued.

“Over the years, Jill and I took care of all four of our parents. We were with our parents to the very end. We could do it. We could afford to do it. We understand. 

“In the pandemic, we made it even clearer just how hard it is for millions of working- and middle-class families to provide care for their families,” Biden said. 

“It’s not just how important the care economy is to the entire economy, it’s when people have to leave the labor force or can’t enter it in the first place because of caregiving responsibility, they can’t fully participate in the economy, and that drags down the whole nation’s productivity and growth overall,” he said.

According to a fact sheet distributed to reporters ahead of the order signing, the cost of child care has soared more than 26% over the past decade, and more than 200% over the past 30 years. 

“The cost of home caregiving for seniors and the disabled has gone up 40% in the last 10 years,” the White House 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. 

A brief from the Boston Consulting Group forecasts losses of $290 billion each year in gross domestic product in 2030 and beyond if the U.S. fails to address the lack of affordable child care.

In an on-the-record briefing with reporters, Domestic Policy Adviser Susan Rice said simply, “Child care and long-term care systems in this country just don’t work well — high-quality care is costly to deliver, it’s labor intensive, it requires skilled workers … Yet care workers — who are disproportionately women and women of color and immigrants — are among the lowest paid in the country, despite working in some of the most important and complex and demanding jobs. 

“At the same time, the price of care represents an outsized share of a family’s budget,” she added.

The order signed by the president on Tuesday directs federal agencies to identify grant programs that can support child care and long-term care for those working on federal projects and to consider requiring those who vie for federal contracts to commit to providing access to these services as a qualifying condition.

The order also directs the federal government 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. 

It goes on to direct the Department of Health and Human Services to consider actions to reduce or eliminate families’ co-payments for child care, and the Department of Veterans Affairs to improve access to home-based care for veterans who need at-home support for their daily activities. 

The order directs HHS to amend existing policies so that more child care providers can benefit from federal Child Care and Development Block Grant funding, and that it also take steps to increase pay and benefits for Head Start employees.

On top of this, the department has been directed to create new rules to make Medicaid payments for home-care services more transparent and ensure a greater share of Medicaid funding reaches home-based workers.

The order Biden signed also directs the Defense Department to take steps to improve the affordability of child care on military installations, and it directs the Office of Personnel Management to conduct a review of child care subsidy policy and consider setting government-wide standards for federal government employees to access such assistance. 

“Why are we doing all of this?” the president asked at one point during his remarks. “Because the cost of care is too high for seniors in nursing homes [and] working families with young children.

“Too many folks lie awake at night wondering, ‘If mom can’t take care of herself at home, what are we going to do? She’ll have to move into a nursing home. Are we going to be able to afford it? Can I still afford to get the kids through college and save for retirement? How do I do it all?’

“No one should have to choose between caring for the parents who raised them, the children who depend on them, and the paycheck they rely on,” Biden added.

Dan can be reached at [email protected] and at https://twitter.com/DanMcCue