Is your state doing enough to support working families? In this eye-opening conversation with Laura Valle Gutierrez, a fellow at The Century Foundation, we break down the third annual State Care Report Card—a comprehensive ranking of all 50 states on childcare, paid family leave, and elder/long-term care. The verdict? Not a single state earned an “A.”
Jeffrey Snyder, Broadcast Retirement Network
Well, Laura, it’s so great to see you. Thanks for joining us on the program this morning.
Laura Valle Gutierrez, a fellow at The Century Foundation
Thanks for having me.
Jeffrey Snyder, Broadcast Retirement Network
Yeah, I’m really impressed by this report. Before we kind of get into the meat of the report, tell us about its origins and why the report that you and your teammates, your colleagues put together is so vital here in the United States.
Laura Valle Gutierrez, a fellow at The Century Foundation
Yeah, so this is our third annual state care report card where we grade all 50 states and the District of Columbia on their care policies. We know that care is a part of U.S. policy that has really lagged behind other countries on the national stage. And fortunately, we’re seeing a lot of states step up and try to fill some of those gaps to support families in the United States that are really struggling with how hard it is to find quality care and how expensive it is to find quality care.
Jeffrey Snyder, Broadcast Retirement Network
So if you were to define care, are we referring to caregiving, home care, health care, or all the above?
Laura Valle Gutierrez, a fellow at The Century Foundation
So our care report card really runs the gamut. We wanted to provide a comprehensive look at care. So it starts from child care and runs all the way to caregiving and disability care.
So we’re looking at caregiving, how easy it is for families to find services for receiving care, but also the working conditions of our care workers.
Jeffrey Snyder, Broadcast Retirement Network
Yeah, obviously, as we have an aging America, more of us are going to need all sorts of type of care from health care to long-term care to home care, you name it, we’re going to need it. Before we get into the report results, how are we doing federally or as a nation? Are we providing enough access across the whole country for people?
So is it equitably being distributed? Can I just go as a regular person, just walk in and get care if I need it?
Laura Valle Gutierrez, a fellow at The Century Foundation
Great question. No, the United States is really far behind where a lot of other countries are. We know that states are trying to step in and fill the gaps, but even the highest scoring state in our report card got a B.
So we know that for most families, finding care is not easy. If you want to find child care, we know that most families live in communities where child care is either not available because the wait lists are too long, there’s not enough supply of child care, or it’s too expensive for families to afford with child care being more expensive than rent or mortgage in a lot of instances. Similarly, not everyone lives in a state that has a paid family and medical leave program.
So if you get sick or if a loved one gets sick, you can’t take time off of work to provide care for them without losing your income, maybe losing your job. So we know that some states, states like California, Oregon, Washington are really trying to do the right thing, invest in child care, invest in aging and disability care, passing paid leave laws to make it easier. But most people are not living in communities where care is easy and affordable.
And this is partly because the United States has failed at the federal level to invest in care policies. We saw some progress during the pandemic. There was a temporary expansion of paid leave programs, unprecedented investments in child care.
Unfortunately, the Trump administration in the most recent bill that they passed, passed the largest Medicaid cuts we’ve seen. These cuts make it harder for states to invest in these programs because they’re getting their state dollars taken away, and they’re having to try to find ways to support caregiving with the federal government taking a step back from these vital investments. So we have a long ways to go.
I think the care report card really highlights some bright spots that we should talk about. But we know that the federal government also needs to step up and do more for families.
Jeffrey Snyder, Broadcast Retirement Network
Yeah. And especially as you mentioned, the cost of care is going up, but so is the cost of groceries, the cost of fuel, a lot of things are going up. And I think a lot of us, you and I included, are feeling the pain there.
So let’s talk about, do you want to start with who’s doing it the best, the top states, or should we start with who maybe needs some improvement? You pick.
Laura Valle Gutierrez, a fellow at The Century Foundation
Yeah. I love to show which states are really doing the best job. So I mentioned a couple of them.
California. So first I’ll start by saying that we’ve had the same five states topping the care report card, every edition that we’ve had it so far. So it’s always California, Oregon, New York, Massachusetts, New Jersey that are topping the list.
Some of these reasons, they were some of the first states to pass paid sick leave laws and paid family and medical leave laws. But we’re also seeing these states put their money where their mouth is. So New York has invested unprecedented levels in their childcare programs and really putting resources towards expanding the supply of childcare and making it more affordable for families.
We saw Virginia, which actually improved its score significantly passing their first paid family and medical leave law. And we saw Washington state who has long been a great leader in terms of care policies. Their long-term care insurance program has begun paying out benefits.
And they also passed a national domestic worker bill of rights. So we’re seeing a lot of momentum across the country from east to west in terms of investing in care policies. And I think some of those bright spots will hopefully show other states what is possible.
Jeffrey Snyder, Broadcast Retirement Network
Yeah. But I think I recall hearing you say that even the top states got a B, are you just a tough grader? Like I had a lot of those teachers in high school and college, or do they still have some room to grow in terms of what they’re providing?
So they’re doing good, but they could do maybe even better.
Laura Valle Gutierrez, a fellow at The Century Foundation
Yes. I think it’s a little bit of both. I think getting an A in a care policy should mean that in that state, whatever it is, care is easy and affordable to find, whether it’s care for an older adult or whether it’s care for a young child.
And so getting an A is a high bar, but it should be because care matters. But we also know that these states have room to improve. So for example, we saw states like Rhode Island actually build progress.
Rhode Island is one of the first states to pass paid family and medical leave. They have strengthened their paid family and medical leave program over the past two years. So we are seeing states like New Mexico continue to build on its endowment for childcare to keep building the supply of childcare, making it free for families.
So states that have received high scores still have room for improvement. That’s why we keep the report card as consistent as possible so that we can track progress over time and see which states are building on those wins.
Jeffrey Snyder, Broadcast Retirement Network
So for states that maybe are not doing as well as they should be, at least according to the scorecard, they say each state’s a laboratory for democracy. So you would think that 50 states in the District of Columbia, there’d be a lot of cross-pollination and sharing. When you think about maybe the lower third of the list, the ones that maybe need improvement, are they able to leverage what’s going on in Oregon, Washington, California, Massachusetts, New Jersey?
If I was a legislator and a governor, not that I have any designs to do that, but I would try to figure out what other people are doing well and then try to bring that into my state. Are they doing that?
Laura Valle Gutierrez, a fellow at The Century Foundation
So I think one of the examples of this is that we’re actually seeing cities. So at the local level, cities across some of the lower scoring states that tend to be in the South actually make progress. So we’re seeing some cities in Southern states begin to enact paid leave programs for municipal employees.
So this isn’t showing up in our care report card because we’re scoring state policies, but we’re seeing sort of inklings of progress at the municipal level, even in these states that have at the state level not made the investments in care that we think are vital. So I think these are the sorts of wins that can scale up over time, show what’s possible even in communities that have historically neglected investing in care and begin sort of raising the ceiling of what we’re expecting state governments to do.
Jeffrey Snyder, Broadcast Retirement Network
Wouldn’t it be in the best interest of the state to have these types of benefits because A, you’d be able to keep your workers. Two, you’d also be able to attract businesses to your state. I’m just thinking from a, you know, again, I don’t run state or a city or anything except the network, but to me, I tried to leverage what I could so I could attract, you know, economically grow my state.
So it would make sense to attract workers and attract employers and provide this worker base, right? I mean, am I missing something?
Laura Valle Gutierrez, a fellow at The Century Foundation
No. So care policies grow the economy. They do this in a couple of different ways.
They reduce turnover for businesses. So for businesses, it actually helps them. We’ve had a lot of businesses speak at the state level about how helpful having policies like paid leave is.
And these are actually policies that help smaller businesses in particular, because it’s often harder for a small business to afford like a big paid leave benefits program compared to a big corporation. So when the state provides it, it makes it easier for them to do that. We also know that things like affordable child care help increase the labor force participation of moms, makes it easier for them to go to work.
That increases state GDP. It also helps the economic security of families that are having to deal with higher grocery bills, higher energy bills. So when we can have two parents that are working, it makes it easier to actually have the money to afford those things.
And that helps the economy as well. So we’ve actually had chambers of commerce in states like Florida come out and say the lack of care investments is actually costing us. And these are policies that can help grow the economy and support families.
So they really are win-wins. And I think we’re seeing that as states are growing and improving on their care policies, we’re beginning to see how important these policies are for families.
Jeffrey Snyder, Broadcast Retirement Network
Yeah. And also, I would say it also incentivizes people to have children. Like if you know that you’re going to get some level of support and have some of these benefits, you’re probably more apt to have more babies.
And that actually would help in a lot of ways economically, but also might help shore up some of these trust funds that Social Security, Medicare. I mean, we’re looking 18, 20 years down the road to the kid can work, but it seems like that would help incentivize that. Let me get back to the federal approach, because much like privacy laws and other laws that states kind of take up, would it be helpful to pick this up, someone to pick up the mantle and whether it’s in the Congress, in the Senate, in the executive branch, somewhere to kind of pick things back up and say, look, we need to have a national approach.
That would probably make it easier for states.
Laura Valle Gutierrez, a fellow at The Century Foundation
Yes, absolutely. So I think that shows up in a lot of different ways. First, we can look at the pandemic as an example, when the federal government actually invested in childcare, sent money to the states.
And with this funding, states were able to actually throw the supply, stabilize the workforce and innovate. So states were able to do things like grants for workforce retention that they hadn’t done before to actually build the care workforce, which is one of the most underpaid workforces in the country. So federal funds are really important from that regard.
On the other side, we’re seeing the cuts that the Trump administration passed for Medicaid already panning out. So because states, they can’t run deficit budgets, right? So states have to make sure that every dollar that’s going out is actually accounted for.
And so with these cuts to Medicaid, which is the biggest funder of home and community-based services, we’re seeing states pull back on their home and community-based services. These are services that are really vital for people that are aging and that have disabilities to receive care in a setting at home with the dignity that they deserve. So already these cuts are starting to have impacts on communities across the country.
So we need not only to sort of come back in and restore the funding that has been cut, we need to actually grow that funding so that states can build the supply that is non-existent. So we have a supply shortage when it comes to care because of a lot of the issues regarding the low pay for the workforce. So we need to be paying care workers the wages that they deserve to build the supply and to make sure that there’s actually enough of these services to meet the demand, especially in an aging country.
Jeffrey Snyder, Broadcast Retirement Network
Yeah. Well, as someone who’s aging, I guess we’re all aging, but as someone who’s maybe nearing the age where he and his wife may need some help, I would like to see us really bolster that, not only here in North Carolina, but across the United States. Laura, we’re going to have to leave it there.
Great report. Thanks so much for joining us and we look forward to having you back on the program again very soon.
Laura Valle Gutierrez, a fellow at The Century Foundation
Thank you.
