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This brief was developed for Health Affairs and is available on its website.

This brief explores how the Child Care and Development Block Grant (CCDBG) could, if fully funded and implemented, improve health and well-being by supporting parental work and improving access to high-quality child care across the full range of settings. Its key points are as follows:

• Nonparental child care is a key support for working parents and can contribute to long-term child health and development. Yet high-quality affordable care that meets parents’ needs can be hard to find.
• The Child Care and Development Block Grant is the primary public child care program in the US. It supports low-income parents’ employment and children’s development and contributes to the well-being of families by helping parents pay for care. It serves 1.3 million children, only 15 percent of those who are eligible under federal law.
• The CCDBG was reauthorized in 2014 with changes that strengthened the program’s focus on child care quality and stabilizing families’ access to assistance.
• Meeting both the work support and child development goals of the program is challenging for several reasons. These include inadequate funding; the shortage of high-quality affordable care that meets parents’ needs; and the increased focus of the program on the formal child care sector despite misalignment between the formal child care market and the needs of specific groups of families, such as parents who work nontraditional schedules, families living in rural areas, families with infants and toddlers, and families with children with special needs.
• Full CCDBG funding and implementation is critical to increasing equitable access to high-quality child care that improves the health and well-being of all low-income families. Accomplishing this goal will require a comprehensive approach focused on access and quality, support to child care providers in both home-based and formal settings, and a significant expansion of federal and state funding.