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Build Back Better could be a sea change for American women

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Last month, the House passed the Build Back Better Act after months of negotiations. Before the vote, House Speaker Nancy Pelosi (D-Calif)  said of the $1.75 trillion social policy and climate change bill, “We are proceeding with transformative legislation to drive historic progress.” 

When it comes to women’s lives, her words are far from hyperbole: They’re true. 

Why? Because the bill represents a sea change in social and medical policy crucial to enabling women’s well-being. Many of its initiatives would ameliorate disparities that prevent women from remaining and advancing in the workforce, caring for their children without crippling financial burdens and experiencing safe pregnancies and childbirths to live long, healthy and productive lives. 

It’s critical that the Senate follows suit and passes this bill, with these key provisions intact. 

Consider first the permanent national paid family and medical leave program. The United States is one of just seven countries in the world — and the only wealthy nation — that does not guarantee paid time off to care for a new baby, ill family members or oneself. While the four weeks of paid leave included in the act still pale in comparison to what most countries offer, it’s a step in the right direction. Many of us have known for a long time that paid family leave is essential for women’s workforce participation, their financial stability and this nation’s overall economic growth. The pandemic has now brought home this fact in stark reality. 

As of February, nearly 3 million women had left the workforce due to the pandemic. For many, becoming virtual school teachers overnight, juggling work and safeguarding their family’s health proved insurmountable. If those millions of women are going to reenter the workforce, and thus help lift the economy, they need support to better balance the demands of their families and their careers. Paid leave can do that while also decreasing food insecurity for families and boosting children’s health outcomes. 

Next are the significant provisions for childcare: free universal pre-K subsidies for many families with infants and babies up to age 2, and an extension of the child tax credit introduced during the pandemic through 2022. This is a lifeline for many families. With costs of center-based infant care averaging tens of thousands of dollars, parents, particularly women, simply find it too expensive to keep their jobs. These childcare measures will save families thousands of dollars every year, making it easier for parents to access high-quality care, allowing both parents to work more reliably or return to work. 

Third is increasing earnings for childcare workers, many of whom don’t get paid a living wage. In 2019, the average hourly wage for childcare workers, who are predominantly women, was just $11.65, according to the Center for the Study of Child Care Employment at the University of California, Berkeley. The act includes funding to states to help them expand the supply of childcare providers and improve the quality of care offered. This benefit will help women, who bear a disproportionate burden of the financial and logistical toll of childcare.

But of particular note, and long overdue, are the provisions to address the problem of Black women’s maternal health. With one of the highest rates of maternal mortality in the developed world, the United States stands out for its woeful maternal health outcomes, especially for women of color. According to the Centers for Disease Control, Black women are three times more likely than white women in this country to die from complications related to pregnancy and birth.

With the act including every eligible provision of the Black Maternal Health Momnibus Act, as well as a permanent expansion of yearlong postpartum Medicaid coverage in every state, we could start to see those statistics improve. At more than $1 billion, it is the largest investment in U.S. history aimed at saving women’s lives, resolving the racial disparities in maternal health and advancing birth equity for all women. The funding will go toward combating the social determinants of maternal health such as nutrition, housing and environmental factors; expanding and diversifying the perinatal workforce; strengthening federal maternal health programs; advancing maternal health research at minority-serving institutions and more. This investment in maternal health is long overdue and its impact will be profound! 

These elements of the Build Back Better Act should be celebrated. They shine a light on the stark economic inequalities and health inequities that still define so many women’s lives and signify real progress toward enhancing women’s well-being, including physical and mental health. They will be a boon to the whole nation by strengthening our social cohesion, health outcomes and economic vitality.  

It is imperative that the Senate pass the Build Back Better Act with the paid leave, childcare and maternal health measures included. Women across this nation simply can’t wait any longer for these protections and supports. None of us can.

Martha Nolan, J.D. is a senior policy advisor for HealthyWomen. Monica Mallampalli, Ph.D. is the senior scientific advisor for HealthyWomen.

Tags Build Back Better Act Child care Health Health equity Maternal health Nancy Pelosi Reproductive health Social determinants of health Women's health

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