The Care Economy: Child Care, Paid Leave, Family Caregiving, and Long-Term Security

The strongest objection is that a federal care guarantee becomes an open-ended entitlement that raises payroll costs, crowds out family and private provision, and cannot recruit enough workers. That risk is real. The answer is a defined catastrophic trigger, front-end pluralism, state delivery, participant budgets, workforce investment, public actuarial review, and automatic parameter review. The position holds because forcing impoverishment and unpaid family labor is also rationing, only without a budget line or accountable rule.

Workers, employers, and taxpayers finance leave and catastrophic care. Higher-income households receive less subsidy. Providers accept common reporting and safety duties. Families relinquish some privacy to prove eligibility. Facilities face transition as home care expands. Progressive contributions, data minimization, transition funds, participant choice, and rural adjustments mitigate those costs. The compact accepts them to replace arbitrary family ruin with a shared, reviewable obligation.