III 

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; 


kjohnson on DSK7ZCZBW3PROD with $$_JOB
2 

•SRES 938 IS 

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 


kjohnson on DSK7ZCZBW3PROD with $$_JOB
3 

•SRES 938 IS 

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; 


kjohnson on DSK7ZCZBW3PROD with $$_JOB
4 

•SRES 938 IS 

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 


kjohnson on DSK7ZCZBW3PROD with $$_JOB
5 

•SRES 938 IS 

(2) during the New Deal-era, domestic and agricultural workers were excluded from social programs and 

labor protections, particularly those created by— 

(A) the Social Security Act (42 U.S.C. 301 et 

seq.); 

(B) the National Labor Relations Act (29 

U.S.C. 151 et seq.); and 

(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-topatient ratios that save lives; 


kjohnson on DSK7ZCZBW3PROD with $$_JOB
6 

•SRES 938 IS 

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; 


kjohnson on DSK7ZCZBW3PROD with $$_JOB
7 

•SRES 938 IS 

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-toprison 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 


kjohnson on DSK7ZCZBW3PROD with $$_JOB
8 

•SRES 938 IS 

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 


kjohnson on DSK7ZCZBW3PROD with $$_JOB
9 

•SRES 938 IS 

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 

1 Resolved, That it is the sense of the Senate that— 

2 (1) it is the duty of the Federal Government to 

3 dramatically expand and strengthen the care econVerDate Sep 11 2014 03:56 Dec 24, 2024 Jkt 059200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\SR938.IS SR938

kjohnson on DSK7ZCZBW3PROD with $$_JOB
10 

•SRES 938 IS 

1 omy, healing and supporting the country as we con2 tinue to recover from the COVID–19 pandemic and 

3 face the challenges of the 21st century and beyond; 

4 (2) the obligation described in paragraph (1) 

5 can only be met with far-reaching public invest6 ments, designed to achieve the goals of— 

7 (A) repairing the wrongs of history, includ8 ing by— 

9 (i) acknowledging and addressing the 

10 legacies of exclusion and oppression faced 

11 by caregivers and care workers, particu12 larly women of color and immigrants; 

13 (ii) acknowledging and addressing the 

14 trauma of all those with unmet care needs, 

15 such as— 

16 (I) people of color, including 

17 Black, Brown, and Indigenous people; 

18 (II) Asian Americans, Native Ha19 waiians, and Pacific Islanders; 

20 (III) immigrant, limited English 

21 proficiency, LGBTQIA+, older, low22 income, rural, and deindustrialized 

23 communities; 

24 (IV) people with disabilities; 


kjohnson on DSK7ZCZBW3PROD with $$_JOB
11 

•SRES 938 IS 

1 (V) people who are unemployed, 

2 under-employed, and unhoused; 

3 (VI) people who are incarcerated 

4 or who were formerly incarcerated; 

5 (VII) veterans; 

6 (VIII) survivors of abuse; and 

7 (IX) children and young people 

8 coping with economic and climate dis9 ruption; and 

10 (iii) approaching care policy as part of 

11 a broader agenda of dismantling systemic 

12 racism, sexism, economic inequality, and 

13 other forms of oppression, alongside efforts 

14 to achieve truth and reconciliation, repara15 tions, decarceration, restorative justice, In16 digenous sovereignty, a fair and humane 

17 immigration system, demilitarization, a 

18 Federal jobs guarantee, and economic, en19 vironmental, and climate justice for all; 

20 (B) raising pay, benefits, protections, and 

21 standards for existing care workers, such 

22 that— 

23 (i) care jobs are family sustaining, 

24 paying substantially more than $17 an 

25 hour and offering generous benefits; 


kjohnson on DSK7ZCZBW3PROD with $$_JOB
12 

•SRES 938 IS 

1 (ii) all care workers have— 

2 (I) the right, and have pathways, 

3 to unionize; 

4 (II) the ability to engage in col5 lective action; and 

6 (III) full labor protections, in7 cluding those specified in the Domes8 tic Workers Bill of Rights Act; 

9 (iii) all care workers have access to 

10 adequate paid family and medical leave 

11 that includes paid safe leave and paid sick 

12 time; 

13 (iv) all care workers who wish to form 

14 worker-owned cooperatives have access to 

15 resources and technical support with which 

16 to do so; 

17 (v) all care workers have access to 

18 ample training opportunities, apprentice19 ships, and career ladders leading to higher 

20 compensation, along with other resources 

21 and support, including funding to facilitate 

22 those opportunities; 

23 (vi) all care workers have the man24 dated employer protections they need to 

25 conduct their work safely in general, and 


kjohnson on DSK7ZCZBW3PROD with $$_JOB
13 

•SRES 938 IS 

1 in the event of a pandemic, infectious dis2 ease outbreak, or other disaster, including 

3 having optimal personal protective equip4 ment, optimal isolation protocols, testing 

5 and contact tracing, and paid days off due 

6 to exposure or illness; 

7 (vii) all care workers are safe from 

8 workplace violence, harassment, and 

9 threats to health; and 

10 (viii) all undocumented workers have 

11 pathways to citizenship and full and equal 

12 access to all public benefits, including 

13 health, nutrition, and income support; 

14 (C) creating millions of new care jobs over 

15 the next decade, including as part of existing 

16 and new public jobs programs, subject to the 

17 same principles in subparagraph (B), in the 

18 context of the Green New Deal, public health 

19 and emergency preparedness needs, and any 

20 similar efforts to meet the challenges and op21 portunities of the 21st century; 

22 (D) building and expanding zero-carbon, 

23 non-polluting, climate-safe infrastructure, both 

24 physical infrastructure and social infrastruc25 ture, to guarantee care to all people throughout 


kjohnson on DSK7ZCZBW3PROD with $$_JOB
14 

•SRES 938 IS 

1 the life cycle, moving the United States toward 

2 universal, public programs ensuring— 

3 (i) high-quality health care, including 

4 comprehensive and noncoercive mental 

5 health care coverage, substance use treat6 ment, and reproductive care, free at the 

7 point of service; 

8 (ii) free, high-quality home and com9 munity-based services, without income or 

10 asset tests and without waiting lists, which 

11 would fix the institutional bias of the cur12 rent system, and allow people with disabil13 ities and older adults to receive needed 

14 support and live self-directed lives; 

15 (iii) free, high-quality childcare and 

16 early childhood education including appro17 priate attention to the unique needs of 

18 children and families in the focus on the 

19 first 1,000 days of life, and robust, cul20 turally responsive, and diverse care set21 tings to achieve healthy child development; 

22 (iv) paid family and medical leave of 

23 at least 6 months, with full wage replace24 ment, job protection, and a recognition of 


kjohnson on DSK7ZCZBW3PROD with $$_JOB
15 

•SRES 938 IS 

1 all types of families, as well as paid safe 

2 leave and paid sick time; and 

3 (v) additional support for unpaid care4 givers, people with disabilities, older 

5 adults, and children, with the goal of eradi6 cating child poverty; and 

7 (E) building and expanding other zero-car8 bon, non-polluting, climate-safe infrastructure 

9 and jobs that are intimately connected to the 

10 care infrastructure described in subparagraph 

11 (D), to meet the fundamental material, develop12 mental, emotional, and social needs of all peo13 ple, including— 

14 (i) clean air and water; 

15 (ii) public, permanently affordable, 

16 and dignified housing and transit systems, 

17 integrated with adequate social services to 

18 support residents of all ages and abilities; 

19 (iii) safe, accessible infrastructure, in20 cluding public accommodations, schools, 

21 workplaces, housing, transit, and streets 

22 allowing for full mobility for all people; 

23 (iv) public education, with a focus on 

24 social and emotional learning, unleashing 

25 creativity in the arts and sciences, and 


kjohnson on DSK7ZCZBW3PROD with $$_JOB
16 

•SRES 938 IS 

1 educating and nurturing the whole child, 

2 and including fully funded programs for 

3 high-need students; 

4 (v) healthy, nourishing, and sustain5 able food systems that provide affordable, 

6 accessible, and culturally appropriate 

7 foods; 

8 (vi) comprehensive public health and 

9 emergency preparedness infrastructure, in10 cluding equitable, democratic response and 

11 recovery efforts during and after climate 

12 disasters; 

13 (vii) clear opportunities for, and the 

14 removal of barriers to, unionization and 

15 collective action in all economic sectors, in16 cluding the service, technology, and gig 

17 work sectors; 

18 (viii) a Federal minimum wage of at 

19 least $17 an hour, indexed to the cost of 

20 living, and the elimination of subminimum 

21 wages for people with disabilities, tipped 

22 workers, and all other workers; 

23 (ix) expanded leisure time, with no 

24 loss in pay or benefits; 


kjohnson on DSK7ZCZBW3PROD with $$_JOB
17 

•SRES 938 IS 

1 (x) generous paid sick time, paid safe 

2 leave, paid family and medical leave, and 

3 vacation time, with full wage replacement, 

4 job protection, and a recognition of all 

5 types of families; 

6 (xi) support for worker ownership, 

7 worker-owned cooperatives, and safety and 

8 democracy in the workplace, so that work9 ers have meaningful influence over their 

10 conditions of work and the decisions that 

11 affect their lives; 

12 (xii) adequate public services and pro13 grams to support all people in navigating 

14 economic and social challenges, including 

15 navigating life on a rapidly warming plan16 et, and to help all people unleash their full 

17 potential as human beings; 

18 (xiii) public libraries, community cen19 ters, and other spaces that foster cre20 ativity, connection, well-being, and human 

21 development; 

22 (xiv) support for practicing and aspir23 ing artists, as well as institutions, venues, 

24 and platforms that empower and fairly 

25 compensate artists, bringing their work to 


kjohnson on DSK7ZCZBW3PROD with $$_JOB
18 

•SRES 938 IS 

1 wider audiences, and integrating the arts 

2 into community well-being, education, and 

3 resilience efforts; 

4 (xv) access to nature, public space, di5 verse forms of public recreation, and tech6 nology, including public broadband inter7 net; and 

8 (xvi) mechanisms for democratic over9 sight of data, algorithmic, and techno10 logical systems, along with worker and 

11 community participation in the develop12 ment and application of those systems, in 

13 service of expanding and improving care 

14 and social infrastructures; 

15 (3) all public health, care-related, and economic 

16 legislation must prioritize and invest in care infra17 structure as a down payment on building an inter18 connected, holistic caregiving system that— 

19 (A) is the backbone of the economy and es20 sential to all people; and 

21 (B) celebrates the interdependence of all 

22 people; 

23 (4) unpaid caregivers deserve pay and support, 

24 care workers deserve quality, high-paying, union 

25 jobs, people with disabilities and older adults deserve 


kjohnson on DSK7ZCZBW3PROD with $$_JOB
19 

•SRES 938 IS 

1 independence and self-determination, and every per2 son, at every stage of life, deserves to live, work, 

3 play, and care with dignity; and 

4 (5) our ultimate aim is to build an economy and 

5 society based on care for people, communities, and 

6 the planet we all share. 

Æ 


kjohnson on DSK7ZCZBW3PROD with $$_JOB