CHN’s Human Needs Watch: Tracking Hardship, October 6, 2023


October 6, 2023

October 6, 2023  

The care is infrastructure edition. When Americans think of infrastructure, we tend to think of roads, bridges, tunnels, and railways. And it is true that much physical repair is needed – that’s why Congress passed and President Biden signed bipartisan infrastructure legislation last year. That legislation is funding more than 32,000 projects in 4,500 communities across all 50 states, D.C., and U.S. territories. 

But care is infrastructure as well. When human needs advocates think about care infrastructure, they usually talk about high-quality, accessible, and affordable child care; paid family and medical leave; home- and community-based services (HCBS) and support; and the care workforce. 

How are we doing in America when it comes to care infrastructure? Not very well. On the child care front, billions of dollars of pandemic-era aid just expired; advocates fear this could lead to the loss of 70,000 child care centers, with 3.2 million kids losing care. In five states – Arkansas, Montana, Utah, Virginia, and West Virginia – as well as Washington, D.C., more than half of all child care centers may close, according to The Century Foundation. In another 14 states, one third or more may close. 

Congress has failed to pass paid family and medical leave, and only a handful of states have opted to enact their own policies Unfortunately, proposals in this Congress are unlikely to pass. And the nation faces a dire shortage of care workers – even as millions of Americans join the ranks of the aging each year. 

In the long term, we as a nation must think about what care infrastructure is, why it is important for the aging, people with disabilities, and families with children, and how we must invest in it. In the short term, we can address our child care crisis and greatly improve our economy at the same time. While it is easy to get distracted by political drama in Congress, the stakes are quite high for everyday people.

Tell your senators and representative: increase child care funding today.


1 in 5 

One in five women (20.2%) reported that, at some point in the previous four weeks, children in their households were unable to attend child care, as a result of child care being closed, unavailable, unaffordable, or because they were concerned about their child’s safety, according to a National Women’s Law Center analysis of a recent Census Bureau survey. Black, non-Hispanic women (27.3%) were more likely than White, non-Hispanic men (14.4%) to report not having child care. Tweet this.


Almost 7 in 10 

Nearly seven in ten (69%) women experienced an adverse economic impact from not having child care, such as being forced to take unpaid leave, cut their work hours, leave their jobs, or not look for a job. Tweet this.


$10.6 billion/

$9 billion


The loss of pandemic-era child care assistance will cost the U.S. economy an estimated $10.6 billion annually in tax and business revenue as adults are pushed out of the work force. Families will lose $9 billion in earnings. This will disproportionately affect families in rural areas, families with low incomes, and women and families of color. Tweet this.


1 in 3/ 232,000 

One in three child care centers nationwide could close due to the loss of funding, and 232,000 child care workers could lose their jobs. Tweet this.




The cost of child care has risen 14% over the past five years, with the average cost per child almost $11,000 a year. Tweet this.




The average salary for child care teachers in the U.S. is $13.71 an hour.




The median hourly wage for home care workers was $14.50 in 2022. That’s actually lower than it was in 2021 ($15.22), counting inflation. Their median annual income was only $20,599, because many are not able to work full-time.




15 percent of home care workers were below the poverty line in 2021; 42 percent were near poverty (below 200% of the poverty line).  Because their earnings are so low, more than half received some form of public assistance.




10,000 Americans turn 65 every day. People turning 65 today have a nearly 70% chance of needing long-term care. 80% of care is provided by family members.




Nine out of ten older adults and 95% of  people with disabilities want to receive care in their homes and communities. But 650,000 people are on Medicaid HCBS waiting lists where the average waiting period is 45 months.