[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[S. Res. 938 Introduced in Senate (IS)]
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118th CONGRESS
2d Session
S. RES. 938
Expressing the sense of the Senate that it is the duty of the Federal
Government to dramatically expand and strengthen the care economy.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
December 20 (legislative day, December 16), 2024
Ms. Warren submitted the following resolution; which was referred to
the Committee on Health, Education, Labor, and Pensions
_______________________________________________________________________
RESOLUTION
Expressing the sense of the Senate that it is the duty of the Federal
Government to dramatically expand and strengthen the care economy.
Whereas the preamble of the Constitution of the United States cites the duty to
``promote the general Welfare'', establishing care for the people of the
United States as one of the pillars of our system of government;
Whereas, even before the novel coronavirus disease 2019 (COVID-19) pandemic and
the recession it triggered--
(1) the United States was experiencing profound crises of care and
well-being; and
(2) critical public services and programs in the United States were
under-resourced or nonexistent;
Whereas we are interdependent and, at various stages of life, everyone will give
or receive care;
Whereas care work makes all other work possible, and the economy of the United
States cannot thrive without a healthy and robust foundation of care for
all people;
Whereas over 3,500,000 children are born every year in the United States, and
about 11,000 people in the United States reach retirement age each day;
Whereas, in 2019, the number of adults over 60 requiring long-term care was
around 8,000,000 and that number was expected to triple by 2050;
Whereas, in 2019, more than 1 out of 5 adults in the United States had been an
unpaid caregiver for an adult family member or friend, or for a child
with disabilities, in the preceding 12 months;
Whereas 60 percent of unpaid caregivers worked for pay outside the home, and
most were women;
Whereas over 3,600,000 children and young people in the United States had also
been caregivers for adults;
Whereas, in 2023, women in the United States performed nearly 296 hours per year
of unpaid care work on average, amounting to nearly two-thirds of all
unpaid care work performed and about 102 annual hours of care more than
men on average, and Asian women and Latinas spent about an hour a day
providing unpaid care on average, more than any other group;
Whereas the estimated size of the care economy, including both unpaid and paid
caregiving, is up to $6 trillion, approaching a quarter of total United
States gross domestic product (GDP);
Whereas just as our country's physical infrastructure is crumbling, the Federal
and State programs constituting our care infrastructure are an outdated
patchwork, and quality care is inaccessible for millions of people in
the United States;
Whereas the United States does not guarantee paid time off to give and receive
care, and is the only industrialized country in the world without a
national paid family and medical leave program;
Whereas States throughout the country have created sustainable paid family and
medical leave models that could meet the needs of all people in the
United States;
Whereas, in 2023, only 27 percent of the United States private sector workforce
had access to paid family leave through their employer, while only 6
percent of the lowest wage workers, who are predominantly women and
workers of color, had access to paid family leave;
Whereas Federal law in the United States does not guarantee paid sick days for
workers and, in 2023, 22 percent of workers in the private sector
workforce did not have even a single paid sick day;
Whereas the ability for workers to use paid sick time during the COVID-19
pandemic prevented 400 confirmed cases of COVID-19 per State per day;
Whereas the median cost of a private room in a nursing home facility is $120,304
per year;
Whereas Medicaid--
(1) covers long-term care needs, but with strict income and asset
eligibility requirements; and
(2) has an institutional bias, requiring State programs to cover care
in congregate facilities, while home and community-based services are
optional or limited;
Whereas Medicare generally does not cover long-term services and supports;
Whereas only 7 percent of individuals in the United States aged 50 or older are
covered by private long-term care insurance, which is often
prohibitively expensive while providing inadequate coverage;
Whereas, in 2024, nearly 27,000,000 people, including 3,800,000 children, did
not have health insurance in the United States, over half of them people
of color, and tens of millions more people were underinsured;
Whereas childcare is one of the highest expenses for families in much of the
United States, and public childcare assistance is limited;
Whereas, in 2020, 30 percent of all children under the age of 14 were
potentially eligible to receive childcare assistance through the Child
Care and Development Block Grant (CCDBG) based on Federal income
eligibility, but only 10 percent of these children had access to
assistance;
Whereas the median annual pay of childcare and home care workers is $30,370 and
$33,530, respectively, leading to high turnover and reliance on public
assistance;
Whereas childcare workers are 95 percent women, and home care workers are 87
percent women, and both are disproportionately Black and Hispanic;
Whereas, in 2023, according to the Bureau of Labor Statistics, less than 8
percent of health care support workers and 4.3 percent of personal care
and service workers were members of unions;
Whereas these conditions have historical roots, as--
(1) in the decades following the abolition of slavery in the United
States, Black people primarily worked as domestic and agricultural
laborers; and
(2) during the New Deal-era, domestic and agricultural workers were
excluded from social programs and labor protections, particularly those
created by--
G (A) the Social Security Act (42 U.S.C. 301 et seq.);
G (B) the National Labor Relations Act (29 U.S.C. 151 et seq.); and
G (C) the Fair Labor Standards Act of 1938 (29 U.S.C. 201 et seq.);
Whereas the COVID-19 pandemic underscored that frontline work, including direct
care, childcare, nursing, health care, public and community health,
mental health, domestic, social assistance, education, service, retail,
delivery, food, restaurant, agricultural, and other work, is essential
to the functioning and flourishing of the United States, and to the
well-being of all people;
Whereas, throughout the COVID-19 pandemic and the following recovery period, it
was necessary for frontline workers to engage in numerous strikes and
work stoppages to obtain safe workplaces, personal protective equipment,
the right to shelter in place, and other basic protections for their
health and safety;
Whereas domestic workers, mostly from the global South, were the most common
victims of labor trafficking reported in the United States between 2007
and 2017;
Whereas care and domestic workers who are migrants or immigrants are especially
likely to face wage theft, abuse, and other forms of exploitation;
Whereas hospitals in the United States are understaffed, and most of the country
does not require minimum nurse-to-patient ratios that save lives;
Whereas health care and social assistance workers suffer from the highest rates
of injuries due to workplace violence;
Whereas the closure of rural hospitals is accelerating, and 136 rural hospitals
closed between 2010 and 2021;
Whereas the increased acquisition of healthcare services by profit-driven
private equity firms is rapidly driving up the costs of healthcare and
compromising quality of care across the country;
Whereas 3 of the largest childcare providers in the United States are owned by
profit-driven private equity firms, which creates further risks for care
affordability and quality and worker well-being;
Whereas the decision of the Supreme Court of the United States in Olmstead v.
L.C., 527 U.S. 581 (1999), established the right of people with
disabilities to be independent and supported in their homes and
communities;
Whereas lack of access to technology and broadband internet among people of
color, communities with low-income, communities in rural areas, older
adults, and people with disabilities has negatively impacted the well-
being of those people, particularly during the COVID-19 pandemic;
Whereas, on any given night in 2023, well over 650,000 people were unhoused in
the United States;
Whereas, in 2022, in the United States, 16.3 percent of children, 19.6 percent
of Latino children, 18.8 percent of American Indian and Alaska Native
children, and 18.4 percent of Black children lived in poverty;
Whereas youth suicide rates are rising, and suicide attempts by Black
adolescents increased by 144 percent between 2007 and 2020;
Whereas in the 2020-2021 school year, the Federal Head Start program reached
only 30 percent of eligible children from families with low incomes, and
Early Head Start reached only 9 percent;
Whereas access to high quality childcare and early childhood programs is
associated with--
(1) better long-term socioeconomic, academic, and health-related
outcomes for children; and
(2) increased labor force participation and higher earnings for parents
and families, especially for mothers;
Whereas the historic funds provided for childcare through the American Rescue
Plan led to increased childcare access and increased labor force
participation for women, and the expiration of these resources has led
to a slowdown of that progress;
Whereas a 2019 report found that 14,000,000 students attended schools with a
police officer but no counselor, nurse, psychologist, or social worker;
Whereas mental health professionals, such as school psychologists and
counselors, are best equipped to maintain school safety without pushing
children into the school-to-prison pipeline;
Whereas the youth mental health crisis has been exacerbated by the climate
crisis, COVID-19 pandemic, increased social isolation, and economic
collapse;
Whereas Black, Brown, Indigenous, and low-income communities have borne the
brunt of health impacts arising from fossil fuel use, industrial
pollution, and crumbling infrastructure;
Whereas, increasingly, climate disasters and extreme weather events are leaving
behind communities suffering from widespread trauma and in need of
mental health care;
Whereas nurses, care and social assistance workers, and educators--
(1) have been first responders during climate disasters and extreme
weather events;
(2) are essential for responding to other forms of environmental harm;
and
(3) have taken grave personal risks to help the people they serve;
Whereas worsening climate impacts will make care work more necessary and care
more difficult to administer, disproportionately impacting children,
older adults, and people with disabilities, who risk being separated
from their regular care workers and caregivers;
Whereas, despite the prevalence of low wages and difficult conditions, direct
care jobs, including home care, residential care, and nursing assistant
jobs, are already among the fastest growing in the United States and
represent the largest occupational group in the country;
Whereas estimates indicate that, globally, adequately investing in care work and
expanding care services could create nearly 300,000,000 jobs by 2035;
Whereas communities devastated by deindustrialization and disinvestment are
particularly reliant on care and social assistance work for employment;
Whereas many care, social assistance, and education jobs are relatively low-
carbon occupations, and can quickly become green jobs as certain
physical infrastructures decarbonize, especially transit systems, health
care facilities, and public buildings;
Whereas a robust care workforce will also be required to support a just
transition to a healthy, zero-carbon economy, as other workers shift to
new industries, move across the country, and develop new care needs;
Whereas the multiple crises now facing the United States require not only
unprecedented investments in physical infrastructure, but also similarly
sized investments in social infrastructure, including care
infrastructure;
Whereas public investment in care work supports care workers' increased economic
activity, creating additional jobs throughout the economy;
Whereas we have a historic opportunity to finally build care infrastructure that
is equitable and inclusive, and one in which all people can thrive,
prosper, weather future disruptions, and age with dignity in their own
homes and communities; and
Whereas in the context of addressing and defeating the lasting repercussions of
the COVID-19 pandemic, future public health emergencies, compounding
economic crises, stark income and wealth inequalities, systemic racism,
and climate change, and taking seriously the mandate to ``promote the
general Welfare'', bold investments in care can anchor the rebirth of
our country: Now, therefore, be it
Resolved, That it is the sense of the Senate that--
(1) it is the duty of the Federal Government to
dramatically expand and strengthen the care economy, healing
and supporting the country as we continue to recover from the
COVID-19 pandemic and face the challenges of the 21st century
and beyond;
(2) the obligation described in paragraph (1) can only be
met with far-reaching public investments, designed to achieve
the goals of--
(A) repairing the wrongs of history, including by--
(i) acknowledging and addressing the
legacies of exclusion and oppression faced by
caregivers and care workers, particularly women
of color and immigrants;
(ii) acknowledging and addressing the
trauma of all those with unmet care needs, such
as--
(I) people of color, including
Black, Brown, and Indigenous people;
(II) Asian Americans, Native
Hawaiians, and Pacific Islanders;
(III) immigrant, limited English
proficiency, LGBTQIA+, older, low-
income, rural, and deindustrialized
communities;
(IV) people with disabilities;
(V) people who are unemployed,
under-employed, and unhoused;
(VI) people who are incarcerated or
who were formerly incarcerated;
(VII) veterans;
(VIII) survivors of abuse; and
(IX) children and young people
coping with economic and climate
disruption; and
(iii) approaching care policy as part of a
broader agenda of dismantling systemic racism,
sexism, economic inequality, and other forms of
oppression, alongside efforts to achieve truth
and reconciliation, reparations, decarceration,
restorative justice, Indigenous sovereignty, a
fair and humane immigration system,
demilitarization, a Federal jobs guarantee, and
economic, environmental, and climate justice
for all;
(B) raising pay, benefits, protections, and
standards for existing care workers, such that--
(i) care jobs are family sustaining, paying
substantially more than $17 an hour and
offering generous benefits;
(ii) all care workers have--
(I) the right, and have pathways,
to unionize;
(II) the ability to engage in
collective action; and
(III) full labor protections,
including those specified in the
Domestic Workers Bill of Rights Act;
(iii) all care workers have access to
adequate paid family and medical leave that
includes paid safe leave and paid sick time;
(iv) all care workers who wish to form
worker-owned cooperatives have access to
resources and technical support with which to
do so;
(v) all care workers have access to ample
training opportunities, apprenticeships, and
career ladders leading to higher compensation,
along with other resources and support,
including funding to facilitate those
opportunities;
(vi) all care workers have the mandated
employer protections they need to conduct their
work safely in general, and in the event of a
pandemic, infectious disease outbreak, or other
disaster, including having optimal personal
protective equipment, optimal isolation
protocols, testing and contact tracing, and
paid days off due to exposure or illness;
(vii) all care workers are safe from
workplace violence, harassment, and threats to
health; and
(viii) all undocumented workers have
pathways to citizenship and full and equal
access to all public benefits, including
health, nutrition, and income support;
(C) creating millions of new care jobs over the
next decade, including as part of existing and new
public jobs programs, subject to the same principles in
subparagraph (B), in the context of the Green New Deal,
public health and emergency preparedness needs, and any
similar efforts to meet the challenges and
opportunities of the 21st century;
(D) building and expanding zero-carbon, non-
polluting, climate-safe infrastructure, both physical
infrastructure and social infrastructure, to guarantee
care to all people throughout the life cycle, moving
the United States toward universal, public programs
ensuring--
(i) high-quality health care, including
comprehensive and noncoercive mental health
care coverage, substance use treatment, and
reproductive care, free at the point of
service;
(ii) free, high-quality home and community-
based services, without income or asset tests
and without waiting lists, which would fix the
institutional bias of the current system, and
allow people with disabilities and older adults
to receive needed support and live self-
directed lives;
(iii) free, high-quality childcare and
early childhood education including appropriate
attention to the unique needs of children and
families in the focus on the first 1,000 days
of life, and robust, culturally responsive, and
diverse care settings to achieve healthy child
development;
(iv) paid family and medical leave of at
least 6 months, with full wage replacement, job
protection, and a recognition of all types of
families, as well as paid safe leave and paid
sick time; and
(v) additional support for unpaid
caregivers, people with disabilities, older
adults, and children, with the goal of
eradicating child poverty; and
(E) building and expanding other zero-carbon, non-
polluting, climate-safe infrastructure and jobs that
are intimately connected to the care infrastructure
described in subparagraph (D), to meet the fundamental
material, developmental, emotional, and social needs of
all people, including--
(i) clean air and water;
(ii) public, permanently affordable, and
dignified housing and transit systems,
integrated with adequate social services to
support residents of all ages and abilities;
(iii) safe, accessible infrastructure,
including public accommodations, schools,
workplaces, housing, transit, and streets
allowing for full mobility for all people;
(iv) public education, with a focus on
social and emotional learning, unleashing
creativity in the arts and sciences, and
educating and nurturing the whole child, and
including fully funded programs for high-need
students;
(v) healthy, nourishing, and sustainable
food systems that provide affordable,
accessible, and culturally appropriate foods;
(vi) comprehensive public health and
emergency preparedness infrastructure,
including equitable, democratic response and
recovery efforts during and after climate
disasters;
(vii) clear opportunities for, and the
removal of barriers to, unionization and
collective action in all economic sectors,
including the service, technology, and gig work
sectors;
(viii) a Federal minimum wage of at least
$17 an hour, indexed to the cost of living, and
the elimination of subminimum wages for people
with disabilities, tipped workers, and all
other workers;
(ix) expanded leisure time, with no loss in
pay or benefits;
(x) generous paid sick time, paid safe
leave, paid family and medical leave, and
vacation time, with full wage replacement, job
protection, and a recognition of all types of
families;
(xi) support for worker ownership, worker-
owned cooperatives, and safety and democracy in
the workplace, so that workers have meaningful
influence over their conditions of work and the
decisions that affect their lives;
(xii) adequate public services and programs
to support all people in navigating economic
and social challenges, including navigating
life on a rapidly warming planet, and to help
all people unleash their full potential as
human beings;
(xiii) public libraries, community centers,
and other spaces that foster creativity,
connection, well-being, and human development;
(xiv) support for practicing and aspiring
artists, as well as institutions, venues, and
platforms that empower and fairly compensate
artists, bringing their work to wider
audiences, and integrating the arts into
community well-being, education, and resilience
efforts;
(xv) access to nature, public space,
diverse forms of public recreation, and
technology, including public broadband
internet; and
(xvi) mechanisms for democratic oversight
of data, algorithmic, and technological
systems, along with worker and community
participation in the development and
application of those systems, in service of
expanding and improving care and social
infrastructures;
(3) all public health, care-related, and economic
legislation must prioritize and invest in care infrastructure
as a down payment on building an interconnected, holistic
caregiving system that--
(A) is the backbone of the economy and essential to
all people; and
(B) celebrates the interdependence of all people;
(4) unpaid caregivers deserve pay and support, care workers
deserve quality, high-paying, union jobs, people with
disabilities and older adults deserve independence and self-
determination, and every person, at every stage of life,
deserves to live, work, play, and care with dignity; and
(5) our ultimate aim is to build an economy and society
based on care for people, communities, and the planet we all
share.
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