•HRES 1617 IH 
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, ap-
proaching 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our care infrastructure are an outdated patchwork, and 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 sustain-
able 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 pri-
vate 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 work-
ers 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; 
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•HRES 1617 IH 
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 in-
come and asset eligibility requirements; and 
(2) has an institutional bias, requiring State pro-
grams 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 assist-
ance is limited; 
Whereas, in 2020, 30 percent of all children under the age 
of 14 were potentially eligible to receive childcare assist-
ance through the Child Care and Development Block 
Grant (CCDBG) based on Federal income eligibility, but 
only 10 percent of these children had access to assist-
ance; 
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; 
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•HRES 1617 IH 
Whereas childcare workers are 95 percent women, and home 
care workers are 87 percent women, and both are dis-
proportionately Black and Hispanic; 
Whereas, in 2023, according to the Bureau of Labor Statis-
tics, 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 agricul-
tural 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, domes-
tic, 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 fol-
lowing recovery period, it was necessary for frontline 
workers to engage in numerous strikes and work stop-
pages to obtain safe workplaces, personal protective 
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•HRES 1617 IH 
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 re-
ported in the United States between 2007 and 2017; 
Whereas care and domestic workers who are migrants or im-
migrants 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 vio-
lence; 
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), estab-
lished the right of people with disabilities to be inde-
pendent and supported in their homes and communities; 
Whereas lack of access to technology and broadband internet 
among people of color, communities with low-income, 
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•HRES 1617 IH 
communities in rural areas, older adults, and people with 
disabilities has negatively impacted the well-being of 
those people, particularly during the COVID–19 pan-
demic; 
Whereas, on any given night in 2023, well over 650,000 peo-
ple were unhoused in the United States; 
Whereas, in 2022, in the United States, 16.3 percent of chil-
dren, 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 chil-
dren 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 at-
tended schools with a police officer but no counselor, 
nurse, psychologist, or social worker; 
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