Meet Tonia
If we want quality child care, then we need to give care workers health coverage
Tonia McMillian knows how to take care of kids.
But she also knows the hard truth that so many people who work caring for young children have to face: they can’t afford to get sick.
Tonia is a licensed, home-based child care provider. Even with the health insurance subsidies offered through Obamacare, the premiums and co-pays were high.
From her story in EdSource:
While sitting in the waiting room to see a physician or getting wheeled into an emergency room, my mind was not able to focus on my health. Instead, all I could think about was how much this was going to cost and please, Lord, don’t let the doctor say I had to be admitted to the hospital. The absolute terror of the mounting cost of health care services was overwhelming.
Like clockwork, the hospital bills started arriving weekly. Whenever I saw the Kaiser return address on each envelope as I had done so many times, my stomach would knot up and my mood quickly soured.
It is painful to work in a field where my services did so much good for the economy and families, yet my family and my health suffered…Family child care providers are independent contractors and, for most of us, access to an affordable health care plan is limited or nonexistent.
Tonia posits that the lack of access to quality affordable health care is one of the reasons that many child care providers die an early death. Evidence shows that the lack of health insurance increases the likelihood of an early death, and family child care providers, like Tonia, are often not in a position to take advantage of the lower premiums and better coverage with employer-sponsored health insurance.
This is literally killing the people who take care of our children.
That this is happening is because we have continued to enact and support policies that do not prioritize care, nor do we have infrastructure in place to pay a living wage to child care providers. Most parents aren’t able to pay more for the care they receive, and we do little, policy-wise, to assist. This includes the lack of paid leave and sick leave for parents, and shrinking tax incentives like the Child Tax Credit to help offset the (very high) cost of raising a child.
Part of the tragic irony of Tonia’s story is that she lives in California, a state known for having robust social policies. California created the first paid family leave program and has one of the highest minimum wages in the country It is also the home of the Child Care Providers United, a union for early educators that Tonia is part of. CCPU has negotiated a health care reimbursement benefit for providers that have at least one child on subsidies in their programs. But, as Tonia explains, this is not health insurance nor does it offer a health care plan. And for the many providers who have kids whose families pay market-rate, they still won’t qualify.
Tonia writes:
We already know that child care is in crisis, statewide and nationally. We need healthy early educators and child care professionals on the job. Child care workers put their lives on the line during the pandemic. In the face of any emergency, these women always bridge the gap and show up when things can appear dire. The least we can do is create a pathway for these professionals to be healthy.
Child care is in crisis of our own making.
If we want people to provide care for children, then we need to make sure that they, too, have health care coverage for themselves and their families.
This isn't a hard policy to understand.
This isn’t even a hard policy to implement.
What is hard is changing the generations-old mindset about the way people view child care: it’s not a teenage babysitter living with her parents and earning spending money, this is the livelihood of people who do 10-12 hours a day of time and energy-intensive work.
We need more stories like Tonia’s out there.
We need more people to speak up.
And we need to begin to understand that changing this system doesn’t mean creating more band-aid solutions like the health care reimbursement fund. It’s a good start, but, as Tonia has written, it doesn’t quite fix the problem.
We need to change the way our policies support families.
And this includes the way our policies support care workers.
Quick note to add for the readers who are writers: Tonia is one of the many stories we’ve included in the child care reporting grants through the Better Life Lab at New America. This current round is closed, but please keep your eyes out here for an announcement about future opportunities. If you are a reporter who is passionate about elevating the stories surrounding care and early education in this country, then I’d love to hear from you!
Parts of this essay have been excerpted from Tonia’s story in EdSource: It Hurts Not To Have Access to Affordable Health Care