North Carolina Could See Boost in Child Care, Health Care, Paid Leave, and Housing if Congress Acts

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By Sarah Ovaska

November 4, 2021

The “Build Back Better” legislation, a benchmark for President Biden’s administration, faces opposition from Republicans.

North Carolinians could have free pre-K, help paying for in-home care for ailing seniors,  and guaranteed paid family leave if Congress acts soon on the Build Back Better Act, one of the Biden Administration’s top priorities. 

The US House of Representatives may take a vote Thursday on their version of President Biden’s pivotal economic recovery package.

If it passes, it’d then head to the U.S. Senate where Democrats need support from half of the chamber’s 100 senators for passage. (Vice President Kamala Harris serves as a tie-breaker when a vote is split down the middle.). 

To pass in the Senate, the legislation will need the support of Sens. Kyrsten Sinema (D-Arizona) and Joe Manchin (D-WV), two Democrats who have wavered on pieces of the bill.  

North Carolina’s two senators, Richard Burr and Thom Tilis, frequently side with their Republican colleagues on issues like this, and are anticipated to also be “no” votes on this one. 

“Paid family and medical leave, including maternity leave, is a lifeline for parents in the workforce,” US Rep. Alma Adams, a congresswoman from Greensboro, said this week. “A pregnancy or medical emergency should never be the reason someone loses their paycheck or their job.” 

The proposals included in the Build Back Better Act are meant to counter many of the anchors weighing down everyday Americans stretched thin by housing, childcare, education and healthcare costs. 

Democrats are hoping to get some version of the far-reaching legislation passed this week, but it’s down to the wire for negotiations. Here’s what’s still in the plan as President Biden tries to pin down the Congressional votes he needs to get it passed. 

Paid Family Leave 

If this is ultimately adopted, it will mean the United States will join most of the world’s nations in making sure workers will be paid when out sick or on leave because of a new child. 

Right now, the United States is one of only six in the world that doesn’t have any national paid leave program. North Carolina doesn’t require anything at the state level, so this would be a big change for all of us in North Carolina.  

The House proposal passed Thursday guarantees four weeks of paid leave, down from the 12 weeks initially talked about. But the four weeks are a significant change from a negotiated framework Biden announced last week which didn’t include guaranteed paid leave.

Health Care Coverage for the Uninsured 

Health insurance coverage for uninsured adults may finally be coming to the dozen states, like North Carolina, that haven’t yet expanded Medicaid. This means an extra 500,000 people in the state would no longer have to go without health insurance. 

Extending healthcare coverage has had lots of positive effects in the states that took up the federal government’s offer to pay for most of the cost, with studies showing that people’s debt levels have gone down while cancers are being detected and treated earlier. 

The Build Back Better infrastructure plan also includes a year’s worth of Medicaid coverage for new mothers who qualify. 

A 2021 federal COVID relief package temporarily granted that coverage,  but Democrats and Biden want to make it permanent. It’s meant to address higher rates of maternal deaths and health complications among Black women in the United States. 

Hearing Benefits for Seniors 

Another proposal in the Build Back Better Act is hearing benefits for seniors, which aren’t currently covered by Medicare, the federal health care program for those over 65.

Hearing aids are expensive, from $1,000 to $6,000, and an estimated 70% of seniors over 70-years-old need hearing aids but don’t have them, according to the White House. 

Aiding Families with Child Care Costs 

Help with really high child care bills and free pre-K is also likely coming. 

Childcare help was one of the most popular pieces of the whole package, with 80% of Americans recently signaling support for it.

Under the current proposal, subsidies will kick in after a family spends 7% of their household income on childcare. Most families are paying much more than 7% of their household income, with the average annual cost for a toddler in a North Carolina child care center coming in at more than $8,700. 

Meanwhile,  free pre-K for 3- and 4-year-olds is also included in the package. Only 30% of the state’s 3- and 4-year-olds go to publicly-funded preschools right now. Experts in early childhood education say such programs are crucial for learning, and could play a part in combating achievement gaps between children from poor and affluent families. The federal program would allow more than 150,000 North Carolina children access.

Housing Help 

Biden’s administration has described the legislation’s boost to affordable housing as the most significant federal investment ever. 

This will include programs to pay for the removal of lead paint from homes, more rental assistance and safety improvements at Section 8 housing locations, and down payment assistance to help first-generation homebuyers secure housing. 


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