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Illustration: Sarah Grillo/Axios

Parents looking to return to the job market may find child care options have gotten pricier — and that's if they can enroll their kids at all.

Why it matters: The fate of the recovery partially relies on the return of parents who left the workforce to care for their children.

  • Federal Reserve Chair Jerome Powell told lawmakers on Tuesday the lack of participation by caretakers is holding back the labor market.

What to watch: An index that tracks day care and preschool costs has shot well above its pre-pandemic level. Its biggest monthly increase in two years happened last month.

  • Child care costs have been growing twice as fast as inflation since 2000, says Rasheed Malik, a policy analyst at the Center for American Progress.

Flashback: At the onset of the pandemic, massive under-enrollment helped push 1 in 10 child care centers to close permanently, Malik says.

What's happening: Higher costs for things like gloves for changing diapers and food for meals are getting passed on to families.

  • "Right now we have no choice but to go back to the paying parents [with price hikes] — those that don't qualify for any subsidy or child care assistance," says the National Childcare Association's Cindy Lehnhoff.

Another cost stems from the issue plaguing other low-wage industries: worker shortages. Child care centers are upping pay — by an average of $2 per hour — to lure back the exodus of child care workers, says Lehnhoff.

  • Staff shortages mean fewer slots for children, making a pre-pandemic problem even worse.

What to watch: The child care industry got over $50 billion in pandemic-era relief — with the biggest chunk set to be disbursed by states in coming months.

Go deeper

Sen. Patty Murray: Pre-pandemic, child care costs a "silent epidemic"

Photo: Axios

Prior to the COVID-19 pandemic, figuring out and affording child care was a "silent epidemic" for working parents, Sen. Patty Murray (D-Wash.) said at an Axios event on Wednesday.

Why it matters: The pandemic has pushed the child care conversation into the forefront. In April, the White House announced that it would release $39 billion from the American Rescue Plan to address the child care crisis stemming from COVID-19.

Updated Jul 1, 2021 - Axios Events

Watch: A conversation on future access to care

On Thursday, July 1, Axios senior editor Sam Baker and health care editor Tina Reed took a closer look at strengthening care accessibility and the future of providing care in our monthly Vitals "Check-Up" series, featuring CMS Administrator Chiquita Brooks-LaSure and Rep. Ami Bera (D-Calif).

Chiquita Brooks-Lasure unpacked how CMS plans to prioritize initiatives in the aftermath of the pandemic, focusing on critical topics such as health equity, prescription drug costs, telehealth, and Medicaid.

  • On the path to improving health equity policy: “The first way that we are really focused on advancing health equity is making it the first question and not the last question. So every single policy that is coming to me, the team knows that I'm going to ask about health equity. They automatically start talking about...how we're going to build in health equity, whether it's making sure that we're collecting data so that we can make better decisions or whether it's just making sure that we're looking at the policies through [a health equity] lens. As we start doing it, the policies improve.”
  • On moving forward with telehealth: “I've heard so much in my own life and from many members of Congress about how important telehealth has been to communities, particularly in the mental health space and...what a difference it made in terms of even in terms of hospitals, in terms of people showing up for their appointments. Telehealth remains critical. So that's going to be an important piece that CMS will be looking at as we look to make some of these policies more permanent.”

Rep. Ami Bera discussed how the landscape of American public health has changed in the past year and what opportunities arose as a result of these issues being exposed.

  • On the healthcare system getting back to normal after COVID-19: “There is going to be this pent-up demand that potentially overwhelms the system as we come out of the pandemic. On top of that, you've got a health care workforce that really was stretched thin throughout the pandemic...We do worry about the potential retirements in that workforce. So we've got to figure out how to work through this backlog of necessary care.”
  • On being strategic about building American health infrastructure: “Let's actually build a public health department and public health infrastructure in America that we deserve. That'll help us deal with community-based issues like other infectious diseases, vaccinations, clean water, health, etc., those are measures that are hugely important, that can have a real impact.”

Axios Chief People Officer Dominique Taylor hosted a View from the Top Segment with Executive Vice President and Associate Chief Medical Officer at UnitedHealth Group, Dr. Margaret Mary Wilson who discussed specific issues that the pandemic brought to light regarding American healthcare, and what that means for the future.

  • On advancing care after the pandemic: “The COVID pandemic drove a significant pivot in the way we all view health care and really gave momentum to the urgent need for health care transformation. It revealed gaps in our healthcare system, but then also drove fresh thinking around how we interact with patients [and] urgency around innovation. Every single person, regardless of their status group, should be assured of optimal, quality, affordable care that meets their specific needs.”

Thank you UnitedHealth Group for sponsoring this event.

NWA hospital, med school to add residency slots for specialty care

Illustration: Brendan Lynch/Axios

The University of Arkansas for Medical Sciences Northwest Regional Campus and Washington Regional Medical Center will increase the size of their residency programs in order to train more doctors locally, including in specialty care.

What's happening: The Arkansas Legislative Council approved $12.5 million for startup costs, such as recruiting faculty. The federal government will pay for long-term costs, such as resident salaries, Nelson Peacock, Northwest Arkansas Council CEO and president, tells Axios.

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