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[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[S. Res. 938 Introduced in Senate (IS)]

<DOC>

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.
                                 <all>
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