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 INSIGHTi 
 
Child Care in the “Build Back Better Act” 
Updated November 10, 2021 
On November 3, 2021, the House Rules Committee released a modified version of the “Build Back Better 
Act” (H.R. 5376) in Rules Committee Print 117-18. This version would establish a “Birth Through Five 
Child Care and Early Learning Entitlement” (§23001). A White House Fact Sheet indicates the combined 
costs of the Birth Through Five program and a Universal Preschool program would total $400 billion—
$50 billion less than the estimate in a September fact sheet from the House Committee on Education and 
Labor, based on earlier versions of these proposals.  
Appropriations 
Section 23001 would appropriate mandatory funding to the Department of Health and Human Services 
(HHS) for child care programs in states, Indian tribes, tribal organizations, and territories. Funding for 
activities in FY2022-FY2024 would be capped. State appropriations for these years would be designated 
for particular activities (Table 1), including direct services (e.g., subsidies, payment rates), quality (e.g., 
supply-building, facilities), and administration. Beginning in FY2025, appropriations for states, tribes, 
and territories would be set at “such sums as may be necessary” to ensure funds are sufficient for all 
eligible children seeking assistance. Capped funding would be available for grants to localities and Head 
Start expansions in states that opt not to participate in the program.  
Congressional Research Service 
https://crsreports.congress.gov 
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Table 1. Birth Through Five Appropriations 
(In billions) 
  
FY2022 
 
FY2023 
  FY2024   
FY2025 
 
FY2026 
FY2027 
Statesa 
 
   
   
   
   
 
Direct services 
11.460   
16.235   
20.055   
   
 
 
Quality  
5.730   
8.118   
10.028   
   
 
 
Direct services or 
 
 
 
such sumsb   
such sumsb 
such sumsb 
quality 
4.126 
5.845 
7.220 
Administration 
1.604   
2.273   
2.808   
   
 
 
Indian 
 
 
 
 
tribes/organizations 
0.960 
1.360 
1.680 
such sums 
such sums 
such sums 
Territoriesc 
0.120   
0.170   
0.210   
such sums   
such sums 
such sums 
Localities 
0.000   
0.950   
0.950   
0.950   
0.950 
0.950 
Head Start expansion 
0.000   
2.850   
2.850   
2.850   
2.850 
2.850 
 
 
 
 
1.06% of total  1.06% of total 
Federal administration 
0.130 
0.130 
0.130 
0.130 
prior-year 
prior-year 
state 
state 
appropriation 
appropriation 
Total 
24.130   
37.930   
45.930   
—   
— 
— 
Source: CRS analysis of Rules Committee Print 117-18. 
Notes: Such sums = such sums as may be necessary. Totals may not sum due to rounding. Appropriations would generally 
remain available through FY2027, but are shown in the year for which the funds were designated to carry out activities. 
a.  Includes Puerto Rico in FY2022-FY2024. 
b.  Quality spending for each of FY2025-FY2027 would be set at 5% to 10% of total prior-year payments to the state. 
c.  Includes American Samoa, Guam, Northern Mariana Islands, and U.S. Virgin Islands in all years. Includes Puerto Rico 
in FY2025-FY2027. 
State Spending 
Funds provided by the section shall supplement, not supplant, other federal, state, and local spending on 
child care based on average spending in FY2019-FY2021. Additionally, states must meet maintenance-of-
effort requirements in all years, set at the average of state spending in the preceding three years.  
Spending in FY2025-FY2027 would be subject to federal-state matching rules that vary by activity. The 
federal share would be 95.440% of expenditures for direct services, an enhanced Medicaid matching rate 
for quality activities, and 53.022% for administrative costs. Federal rates would be set slightly higher than 
under prior versions of the bill, perhaps reflecting an expectation that federal payments may be subject to 
reduction through mandatory sequestration.   
States would cover the nonfederal share with state or local funds, or philanthropic or private donations. 
(For quality and administrative costs, this could be provided in cash or in kind.) States could count 
existing spending toward their nonfederal share, though dollars counted as nonfederal share generally 
should not be considered nonfederal share for another federal award. 
  
Congressional Research Service 
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Eligible Children 
Eligible children would generally be those ages 0-5 (and not yet in kindergarten) with family incomes at 
or below  
  100% of state median income (SMI) in FY2022,  
  125% of SMI in FY2023,  
  150% of SMI in FY2024, and  
  250% of SMI in FY2025-FY2027.  
(In FY2022-FY2024, subject to HHS approval, states could serve children with incomes up to 250% of 
SMI if income-prioritization rules are met.)  
A child’s parent/s generally must participate in an eligible activity (e.g., employment, job search, 
education/training, family leave). Certain vulnerable children and children with a parent over 65 would be 
exempt from parental activity requirements. HHS would set eligibility rules for tribal children, which may 
not be more stringent than rules for other children. 
Eligible Child Care Providers 
Eligible child care providers must (1) be licensed, (2) participate in the state’s tiered system for measuring 
quality (within three years), and (3) meet health and safety requirements under the Child Care and 
Development Block Grant (CCDBG) Act. Certain CCDBG-eligible providers in good standing would be 
considered eligible for 3½ years. 
Within 2½ years of receiving funds, states must have licensing standards and pathways for providers 
seeking licensure to be made eligible. (Presently, states may exempt some providers from licensing rules 
and licensure pathways may not always exist.) 
Within three years, states must have a tiered system for measuring the quality of participating providers. 
The top tier must use standards that are, at minimum, equivalent to Head Start performance standards. 
The system must help providers at lower tiers progress to higher tiers. States must assure that within six 
years of enactment, all families can choose a provider at the highest tier. 
Payment Rates  
Within three years of receiving assistance, states must certify that child care payment rates would be set 
using a cost estimation model or study approved by HHS. Rates must use the most recent estimates/study, 
be updated annually for cost-of-living changes, and reflect providers’ quality ratings. Rates must be 
adequate to ensure providers can pay wages that are equivalent to those of elementary educators with 
similar credentials and experience and that are, at minimum, living wages. States must, within three years, 
have a wage ladder for staff of certain providers. 
Family Copayments 
Participating families with income at or below 75% of SMI would have no copayment for child care. 
Copayments would increase with income until reaching 7% of family income for those with incomes 
above 150% of SMI. Certain populations would be exempt from copays (e.g., vulnerable children, those 
eligible for Head Start). States must prohibit child care providers from charging families more than the 
required copay. 
  
Congressional Research Service 
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Author Information 
 
Karen E. Lynch 
  Conor F. Boyle 
Specialist in Social Policy 
Analyst in Social Policy 
 
 
 
 
 
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IN11750 · VERSION 5 · UPDATED