Child Health

What the Build Back Better Compromise Means for Children and Families

November 2, 2021 | National

Published 11/02/21; Updated 12/02/21

12/02/21 Update: On November 19, the House passed legislation that included federal investments in a first-ever permanent family and medical leave program. A clear, certain, and permanent pathway to citizenship remains uncertain. As the Senate next prepares to take up and pass their version of the bill, they must ensure the final package is as strong and inclusive as possible. Tell your Senators to vote “yes” on historic investments in children and families.

Last week, President Biden released an updated Build Back Better framework, and the House Democrats responded by releasing a compromise Build Back Better bill. This bill is not yet finalized, and as negotiations continue, we may see more changes to what’s included. 

The compromise bill includes important generational investments to boost families’ economic stability and reduce racial inequities in income, housing, education, and health care that disproportionately harm Black, Latino, and Indigenous children. However, it leaves out important investments to ensure children and families have what they need to thrive.

Here’s what’s currently included in the Build Back Better Act (BBB):

    • Extension of the improved Child Tax Credit (CTC) for only one year and permanently ensuring that families with little or no income will be eligible. That means families will still get monthly payments of $300 for children under 6 and $250 for children 6-17 for one more year. Though the bill falls short of making the full expansion permanent, it includes improvements to make the credit fully inclusive so that it reaches more children, including 1 million immigrant children with ITINs (an important provision that President Biden’s framework had actually left out). The CTC expansion already lifted 3.4 million children out of poverty in September 2021 alone and continues to help families take care of their children. 
    • Funding to help families pay the rent and stay safely housed, including $25 billion for rental assistance, $65 billion to repair and renovate public housing units, and $15 billion for the National Housing Trust Fund to build and preserve affordable rental homes. These investments will ensure more children are consistently in safe, affordable, and healthy homes.  
    • Investments to help more children get healthy meals in the classroom and beyond. The bill extends free school meals to an additional 9 million children through the community eligibility provision (CEP); extends summer grocery benefits to families with lower incomes under a new Summer Electronic Benefits Transfer (EBT) program; and provides funding to help schools serve more nutritious food options and modernize their kitchen equipment. 
    • Mandatory 12-month continuous eligibility for children in Medicaid and CHIP to prevent children from losing health insurance, improve continuity of care, and promote health equity for children all across the country.
    • Permanent funding for the Children’s Health Insurance Program (CHIP). Despite CHIP’s success in reducing the number of uninsured children and reducing racial disparities in coverage, it still requires action by Congress to maintain funding. BBB makes CHIP permanent so children and pregnant people aren’t left with the worry that their coverage may expire mid-year or mid-treatment. BBB also includes a technical fix to allow states to expand access to CHIP to more children.
    • A federal program to close the Medicaid coverage gap and ensure families get the health care they need. Twelve states have yet to expand Medicaid to adults with low incomes—and we know that when parents have health coverage, children are more likely to have access to health coverage as well. The Build Back Better Act includes a tax credit to ensure adults living below the poverty line in these states can access marketplace coverage between 2022-25, expanding access to Medicaid to 2 million adults.
    • Investments from the Black Maternal Health “Momnibus” to address the Black maternal mortality crisis and better support mothers and babies, including $100 million for local entities to address societal factors that impact the health and well-being of mothers and children, $170 million to grow and diversify the perinatal workforce, and $100 million for maternal mental health equity grant programs. BBB also includes permanent federal funding for states to expand postpartum Medicaid and CHIP coverage from 60-days to 12-months after delivery to ensure parents don’t lose coverage at a consequential time in their health.
    • Investments in universal Pre-K and expansion of quality and affordable child care. Most notably, BBB includes funding to ensure all 3- and 4-year-olds have access to free, high-quality preschool, for the first time ever, and funding to help families cover the costs of child care and ensure families with lower incomes won’t pay more than 7 percent of their income on child care. With more than 80 percent of two-child families paying more for child care than for rent, these policies will ensure families don’t have to choose between child care and other essentials. Together, these provisions will help educate and prepare our children for the future. 
    • Expanded access to higher education. BBB increases the maximum award amount for Pell Grants, which are critical for first generation students, low-income students, and students of color to help build their futures, and ensures DREAMers can access Pell Grants. It also provides investments in Historically Black Colleges and Universities (HBCUs), Tribal Colleges and Universities (TCUs), and other minority-serving institutions (MSIs) to build capacity, modernize research infrastructure, and provide financial aid to students from families with low incomes. 

Here’s what was left out: 

    • Meaningful paid leave so families don’t have to choose between their paycheck and taking care of their family. The original Build Back Better proposal ensured up to 12 weeks of paid family and medical leave for their own health, to welcome a new child, or to care for a family member as well as three days for bereavement leave after the death of a parent, spouse, or child. Many parents and caregivers with lower incomes, disproportionately Black and brown women, do not have paid leave and are not able to take the time to care for a sick loved one or bond with a new baby. About one-third of workers do not have access to any form of paid time off and nearly eight in 10 workers do not have access to paid family leave, and there are stark racial disparities in meaningful access to leave
    • Clear, certain, and permanent pathway to citizenship. Although the bill includes important provisions on immigration, meaningful relief for immigrant children and families remains uncertain. Pathways to citizenship are essential for children’s stability, economic security, and well-being, ensuring children can live without fear of being separated from a parent and lifting a quarter of a million children out of poverty. Children and families can’t continue to wait for clear and certain pathways to citizenship. 
    • Permanent expansion of the Child Tax Credit. Though the CTC has already proven effective at reducing child poverty and racial disparities, the higher CTC amount will only be extended through 2022. This means that families will lose the stability of a minimum monthly income that they’ve come to rely on.  
    • Necessary reforms to make the CTC available to all children. The original proposal included crucial changes to two “child-claiming” rules that restrict access to the CTC. These rules prevent hundreds of thousands of children from receiving the CTC, mostly children who are taken in by relatives when their parents cannot safely raise them. Many children are denied the benefits of the CTC because their kin caregiver does not meet the CTC’s Relationship Test, or because they are taken in by kin too late in the year to meet the Residency Test. Failure to implement these reforms effectively punishes relatives for stepping in to raise children when their parents cannot and threatens children’s safety, stability, and well-being.  
    • Access to tuition-free community college. The original proposal included guaranteed two years of tuition-free community college for all students interested. Though free tuition for community college has been shown to increase access to higher education and increase wages for students of color and low-income students, this provision was left out of the compromise. 

The State of America’s Children 2021 made it clear that even before the COVID-19 pandemic hit, we were failing to provide our children with even the most basic building blocks for success—and the pandemic has only heightened long-standing racial and economic disparities. Though this bill includes important investments, we can’t compromise when it comes to the well-being of children and we can’t wait any longer to meaningfully invest in supports for children and families. Until every child has what they need to thrive, even ‘better’ is not yet good enough. Congress must pursue every option to ensure children and families’ economic security, health, and well-being.