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

What is broken and why it matters

What we would change

1. 1

   Cap childcare burden and build supply. Limit subsidized family payments to a share of income, pay providers from the cost of safe care, and support centers, family childcare homes, relatives, cooperatives, employer care, and public pre-K under common safety and transparency duties.

2. 2

   Create paid family and medical leave insurance. Provide progressive wage replacement for a worker's illness, a new child, family care, military needs, and safety from violence. Finance it broadly so changing employers does not erase eligibility.

3. 3

   Credit unpaid caregivers. Caregiving periods earn Social Security credits and a refundable caregiver allowance. Respite, training, navigation, and mental-health support become standard benefits.

4. 4

   Make home and community the default. Medicaid and federal matching rules should end waiting- list bias against home- and community-based services, while preserving quality facility care when home is unsafe or unwanted.

5. 5

   Create catastrophic long-term-care insurance. After a substantial need or duration trigger, a federal benefit covers qualified home, community, or facility care. People may insure the front end privately or through savings; no family should have to become destitute before public protection begins.

6. 6

   Build and value the care workforce. Public payments must pass through to adequate wages, benefits, training, safe staffing, and career ladders. Immigration pathways can supplement better jobs and domestic training.

7. 7

   Give every family one care plan they control. A consent-based record should coordinate eligibility, schedule, medications, respite, authorized supporters, complaints, and emergency backup. Strict purpose limits prohibit scoring a family's worthiness.