ACCESS TO child & elder care

People have a right to access affordable, high-quality dependent care. Below you can find data sources to help determine your access levels and related resources.

Access to childcare is important for caregivers to be able to maintain employment. Working caregivers spend large portions of their income on childcare, or they have to find alternatives, relying on family members, friends, community members, sometimes forced to leave children unattended.

High-quality care programs have long-lasting positive effects on early childhood development and education. However, these programs are often inaccessible to underinvested communities. Without access to these high-quality programs, children may not receive the same opportunities as others. According to guidance from the U.S. Department of Health & Human Services, childcare shouldn’t cost more than 7% of household income.

In 2022, Child Care Aware of America found that the annual average price of childcare was $10,853. What does this mean?

  • It would take 10% of a married couple’s median income to afford childcare.

  • It would take 33% of a single parent’s median income to afford childcare.

  • In most states, the annual price of childcare for 2 children exceeds anywhere from 1-53% more than the average annual mortgage payment.

  • In all states, the price of center-based childcare for 2 children exceeds average annual rent from 24% to over 100%.

childcare affordability

Child Care Aware (CCA) provides an Annual Child Care Landscape Analysis that shares information on national and state trends including:

State Childcare Price Breakdowns

Child Care Affordability Report

  • Price of full-time center-based and family care (annual)

  • Price of care as a percentage of income

    • Single parent households (median income of single parent) 

    • Includes comparisons for infant, toddler, 4-year old, before/after school, and full-time summer care

  • Price for center-based care compared with poverty levels 

    • Includes comparisons for infant, toddler, 4-year old, before/after schools, and full-time summer care

Definitions

Access to childcare: parents, with reasonable efforts and affordability, can enroll their child in an arrangement that supports child development and parent needs.

Subsidized childcare: government financial support for childcare. Examining the level of access to this in your area can present a path for increasing this.

Affordability of childcare: price of care as a percentage of median household income (price of full time care divided by median household income)

QRIS: “Quality Rating & Improvement Systems” defined by states’ that determine local program standards and recognize nationally accredited care units.

63% of center-based childcare programs in the U.S. participate in their state’s QRIS (9% of which are nationally accredited)

52% of family childcare providers in the U.S. participate in their state’s QRIS (2% of which are nationally accredited)

(CCA—Building a Better Child Care System).

Childcare centers: vary by size, but usually divide children into groups by age, with different childcare and early education professionals to work with each group. Governed by state regulations. (Extension Alliance for Better Child Care).

Family childcare (home-based care): usually provided in personal home by 1 or 2 individuals. Providers are required to register and comply with state regulations. (Extension Alliance for Better Child Care).

ECE (Early Childhood Education): refers to centers and programs that serve children before kindergarten (ages 3-5).

ECCE (Early Childhood Care & Education): refers to centers and programs that serve children before kindergarten and compulsory/state required school age (ages 0-8).

The U.S. Department of Labor Women’s Bureau Interactive Map allows users to view childcare prices as a share of median family income (by age of child) and care setting (by county).

DOL Interactive Map Instructions: Open Tool > Click price selector on the side to choose between center-based or home care of infant, toddler, preschool or school-age children. Click the magnifying glass icon to search the map using your area or address.

CHILD EDUCATION

Childcare is often defined by programs and centers that offer services for children under 6. However, school-aged children often require before and after school care for parents in the workforce. In many areas, public schools offer after school and summer learning programs. However, the quality of the district’s education system impacts these programs and determines their levels of access, affordability, and quality.

ELDERCARE

Medicaid is a key source of coverage for seniors and people with disabilities, including those requiring long-term services & supports (LTSS) and/or home & community-based services (HCBS) to meet daily needs. However, eligibility requirements, rules, and benefits vary by state. Waivers continue to be the primary way that states expand financial eligibility and offer HCBS benefit packages to seniors and people with disabilities.

Lack of national, unified healthcare policy permits state waivers to limit the number of people served. States’ ability to cap HCBS waiver enrollment results in waiting lists when the number of people seeking services exceeds the number of waiver slots available. As of 2018, 41 states reported a HCBS waiver waiting list. See:

State Variation in Medicaid LTSS

State Policy Choices About Medicaid HCBS

Medicaid 101

Many people who qualify for Medicaid also qualify for Medicare. However, long-term care services for seniors are not typically covered by Medicare alone. See Medicaid & Medicare Assisted Living Coverage.

Senior Living Statistics

Data on age demographics, income, poverty, healthcare coverage, and costs: