IV 
117TH CONGRESS 
1ST SESSION 
H. RES. 180 
Expressing the sense of the House of Representatives that it is the duty 
of the Federal Government to dramatically expand and strengthen the 
care economy. 
IN THE HOUSE OF REPRESENTATIVES 
MARCH 1, 2021 
Mr. BOWMAN (for himself, Ms. BUSH, Ms. CLARKE of New York, Ms. 
JAYAPAL, Ms. MENG, Ms. OCASIO-CORTEZ, Ms. PRESSLEY, Ms. WIL-
LIAMS of Georgia, Mrs. WATSON COLEMAN, Mr. CARSON, Ms. NORTON, 
Ms. TLAIB, Mrs. DINGELL, Mr. GARCI´A of Illinois, Ms. JACOBS of Cali-
fornia, Ms. VELA´ZQUEZ, Mr. KHANNA, Ms. LEE of California, Mr. 
JONES, Mr. ESPAILLAT, Mr. BRENDAN F. BOYLE of Pennsylvania, Mr. 
THOMPSON of Mississippi, Mr. HASTINGS, Ms. OMAR, Mr. POCAN, Mr. 
SAN NICOLAS, Mr. COHEN, Mr. NADLER, Mr. BLUMENAUER, Ms. SCHA-
KOWSKY, and Ms. BASS) submitted the following resolution; which was 
referred to the Committee on Education and Labor, and in addition to 
the Committees on Energy and Commerce, Transportation and Infra-
structure, Financial Services, Agriculture, the Judiciary, and Oversight 
and Reform, for a period to be subsequently determined by the Speaker, 
in each case for consideration of such provisions as fall within the juris-
diction of the committee concerned 
RESOLUTION 
Expressing the sense of the House of Representatives 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’’, 
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•HRES 180 IH 
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 cri-
ses of care and well-being; and 
(2) critical public services and programs in the 
United States were underresourced 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 3,700,000 children are born every year in the 
United States, and about 10,000 people in the United 
States reach retirement age each day; 
Whereas nearly 20,000,000 adults in the United States have 
long-term care needs arising from old age or a disability; 
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 out-
side the home, and most were women; 
Whereas over 3,000,000 children and young people in the 
United States had also been caregivers for adults; 
Whereas, in 2019, women in the United States spent an aver-
age of nearly 4 hours per day on unpaid care work and 
housework, 57 percent more hours than men; 
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•HRES 180 IH 
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, in 2018, only 17 percent of the United States work-
force had access to paid family leave through their em-
ployer; 
Whereas the median cost of a private room in a nursing home 
facility is $105,850 per year; 
Whereas childcare is the highest household expense for fami-
lies in much of the United States, and public childcare 
assistance is limited; 
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 and limited; 
Whereas Medicare generally does not cover long-term services 
and supports; 
Whereas only 7 percent individuals in the United States aged 
50 or older are covered by private long-term care insur-
ance, which is often prohibitively expensive; 
Whereas, in 2019, nearly 30,000,000 people, including 
4,400,000 children, did not have health insurance in the 
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United States, over half of them people of color, and tens 
of millions more people were underinsured; 
Whereas the median annual pay of childcare and home care 
workers is $25,510 and $17,200, 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, both disproportion-
ately people of color and immigrants; 
Whereas, in 2020, according to the Bureau of Labor Statis-
tics, 8 percent of health care support workers and 3.6 
percent of personal care and service workers were mem-
bers 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 has underscored that 
frontline work, including direct care, childcare, nursing, 
health care, public and community health, mental health, 
domestic, social assistance, education, service, retail, de-
livery, food, restaurant, agricultural, and other work, is 
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essential to the functioning and flourishing of the United 
States, and to the care of all people; 
Whereas, during the COVID–19 pandemic, it has been nec-
essary 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; 
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 
135 rural hospitals have closed since 2010; 
Whereas Black, Latino, and Indigenous people have all been 
more than twice as likely to die of COVID–19 than 
White people; 
Whereas adults receiving long-term care in institutional set-
tings represent less than 1 percent of the United States 
population, but account for more than one-third of 
COVID–19 deaths in the United States as of the date of 
introduction of this resolution; 
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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, low-income and rural commu-
nities, older adults, and people with disabilities has nega-
tively impacted the well-being of those people, particu-
larly during the COVID–19 pandemic; 
Whereas, on any given night in 2019, well over 550,000 peo-
ple were unhoused in the United States; 
Whereas, in 2019, in the United States, 1 in 7 children, more 
than 1 in 4 Black children, and more than 1 in 5 Latino 
and Indigenous children lived in poverty; 
Whereas youth suicide rates are rising, and suicide attempts 
by Black adolescents increased by 73 percent between 
1991 and 2017; 
Whereas the Federal Head Start program reaches only 36 
percent of eligible low-income children, and Early Head 
Start reaches only 11 percent; 
Whereas 14,000,000 students attend schools with a police of-
ficer but no counselor, nurse, psychologist, or social 
worker; 
Whereas mental health professionals, such as school psycholo-
gists and counselors, are best equipped to maintain 
school safety without pushing children into the school-to- 
prison pipeline; 
Whereas nearly 1 in 4 students, or up to 3,000,000 students, 
has been missing from school during the COVID–19 pan-
demic, and will need additional support both in and out-
side of school to accelerate learning; 
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Whereas the youth mental health crisis has been exacerbated 
by the climate crisis, and has worsened due to the 
COVID–19 pandemic and economic collapse; 
Whereas Black, Brown, Indigenous, and low-income commu-
nities 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 edu-
cators— 
(1) have been first responders during climate disas-
ters and extreme weather events; 
(2) are essential for responding to other forms of en-
vironmental harm; and 
(3) have taken grave personal risks to help the peo-
ple they serve; 
Whereas worsening climate impacts will make care work more 
necessary and care more difficult to administer, dis-
proportionately impacting children, older adults, and peo-
ple 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, residen-
tial 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 communities devastated by deindustrialization and 
disinvestment are particularly reliant on care and social 
assistance work for employment; 
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Whereas many care, social assistance, and education jobs are 
relatively low-carbon occupations, and can quickly become 
green jobs as certain physical infrastructures decarbon-
ize, especially transit systems, health care facilities, and 
public buildings; 
Whereas a robust care workforce will also be required to sup-
port 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 re-
quire not only unprecedented investments in physical in-
frastructure, but also similarly sized investments in social 
infrastructure, including care infrastructure; 
Whereas public investment in care work supports care work-
ers’ 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 dis-
ruptions, and age with dignity in their own homes and 
communities; and 
Whereas in the context of addressing and defeating the 
COVID–19 pandemic, economic crisis, 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 House of Rep-
resentatives that— 
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•HRES 180 IH 
(1) it is the duty of the Federal Government to 
dramatically expand and strengthen the care econ-
omy, healing and supporting the country as we 
emerge 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 invest-
ments, designed to achieve the goals of— 
(A) repairing the wrongs of history, includ-
ing by— 
(i) acknowledging and addressing the 
legacies of exclusion and oppression faced 
by caregivers and care workers, particu-
larly women of color and immigrants; 
(ii) acknowledging and addressing the 
trauma of all those with unmet care needs, 
such as people of color, including Black, 
Brown, and Indigenous people, and Asian 
Americans and Pacific Islanders, immi-
grant, LGBTQIA+, older, low-income, 
rural, and deindustrialized communities, 
people with disabilities, the unemployed, 
under-employed, unhoused, people who are 
incarcerated or who were formerly incar-
cerated, veterans, survivors of abuse, and 
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children and young people coping with eco-
nomic 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, repara-
tions, decarceration, restorative justice, In-
digenous sovereignty, a fair and humane 
immigration system, demilitarization, a 
Federal jobs guarantee, and economic, en-
vironmental, 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 $15 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 col-
lective action; and 
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(III) full labor protections, in-
cluding those specified in the Domes-
tic Workers Bill of Rights Act; 
(iii) all care workers who wish to form 
worker-owned cooperatives have access to 
resources and technical support with which 
to do so; 
(iv) all care workers have access to 
ample training opportunities, apprentice-
ships, and career ladders leading to higher 
compensation, along with other resources 
and support, including funding to facilitate 
those opportunities; 
(v) all care workers have the man-
dated employer protections they need to 
conduct their work safely in general, and 
in the event of a pandemic, infectious dis-
ease outbreak, or other disaster, including 
having optimal personal protective equip-
ment, optimal isolation protocols, testing 
and contact tracing, and paid days off due 
to exposure or illness; 
(vi) all care workers are safe from 
workplace 
violence, 
harassment, 
and 
threats to health; and 
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