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Build Back Better: A Historic Investment in Young Children and Families

On Friday, November 19th, the U.S. House of Representatives passed the Build Back Better Act. The Build Back Better Act includes several provisions that would directly impact Ohio’s pregnant women, young children, and their families, including major investments in child care, preschool, and maternal health coverage.

The House passage of this historic legislation brings us one step closer to building a stronger early childhood education system and improving child and maternal health coverage. However, our work isn’t over. As the Build Back Better Act moves to the U.S. Senate, we need parents, early childhood professionals, advocates, and community leaders like you to urge policymakers to pass the Build Back Better Act!

How would the Build Back Better Act transform the lives of young children, parents, and early childhood professionals in Ohio? The Groundwork Ohio team has compiled the best and latest resources to break it down for you.

Child Care and Preschool

At a time when child care has become a major barrier to parents with young children returning to work and Ohio’s children are not ready for kindergarten, quality affordable early childhood education is an essential investment in our children, families, and economy. The COVID-19 pandemic has reinforced that early childhood educators the workforce behind the workforce – are critical to the success of our children, families, and businesses.

As First Five Years Fund explains, the Build Back Better Act would not only save families thousands of dollars in child care and preschool costs, but it would also build a strong early learning system that meets the needs of young children, families, providers, and our economy. In fact, the average Ohio family will save an estimated $8,793 in child care costs each year under the Build Back Better Act.

Here are other key facts about the child care and preschool provisions in the Build Back Better Act:

  • Expands access to high-quality, affordable child care to roughly 20 million children nationwide including about 720,000 young children ages 0-5 in Ohio per year. The plan will cover 9 out of 10 families with young children across Ohio.

  • Limits child care costs for the vast majority of working families to no more than 7% of their income.

  • Supports providers with increased wages to shore up and strengthen the child care workforce.

  • Guarantees access to free, high-quality preschool for more than 6 million children nationwide – including more than 151,420 additional 3- and 4-year-olds in Ohio – each year and increases the quality of preschool for many more children already enrolled.

  • Enables parents to send their children to high-quality preschool in the setting of their choice – from public schools to home-based and center-based child care to Head Start.

For more information, check out this FAQ from First Five Years Fund.

Infant and Early Childhood Health

Children who are born healthy and have access to quality health care services have better physical, mental, and emotional health throughout their lives. The Build Back Better Act includes numerous provisions that promote children’s health coverage, ensuring that more children have access to the health care they need to thrive:

  • Requires 12-month continuous eligibility for the Children’s Health Insurance Program (CHIP) and Medicaid coverage for children.

  • Permanently extends federal CHIP funding to avoid potential gaps in children’s coverage caused by delays in reauthorization by Congress.

  • Prohibits states from reducing income eligibility or imposing barriers to CHIP coverage for children and families.

  • Permanently extends the Express Lane Eligibility (ELE) option, allowing states to expedite and simplify enrollment in Medicaid and CHIP by relying on findings from other agencies' eligibility determinations. Only seven states currently use ELE in their Medicaid programs or in both their Medicaid and CHIP programs. Permanency may spur more states to adopt the option.

  • Incentivizes states to expand home- and community-based services and access to those services for individuals in need of long-term care, including children with special health care needs.

Maternal Health

The health of babies is intrinsically linked to the health and well-being of their mothers. As a new report from March of Dimes shows, Ohio continues to face a maternal and infant health crisis. Policymakers must leverage every tool at their disposal to improve the health outcomes of our infants and mothers.

There are several provisions in the Build Back Better Act that would help Ohio respond to the state’s infant and maternal health crisis:

  • Requires that all states extend full-benefit postpartum Medicaid coverage from 60 days after the end of pregnancy to one year postpartum. The mandatory measure would begin as early as January 1, 2023. Through the federal American Rescue Plan Act (ARPA) and the Ohio Biennial Budget (House Bill 110), 12-month postpartum Medicaid coverage in Ohio will begin April 1, 2022.

  • Includes a new Medicaid pathway to incentivize high-quality team-based care for pregnant and postpartum people. According to the Georgetown Center for Children and Families, “The new option also has potential to ensure postpartum care is managed alongside that of newborns during the 12 months after birth, recognizing the parent-child relationship that underpins early brain development.”

Additionally, the Build Back Better Act includes significant investments to train and diversify the perinatal workforce, including providers of color who treat maternal mental health conditions and substance use disorders. The Build Back Better Act also includes new funding for maternal health quality improvement, grants to support implicit bias training for frontline health care workers, better data systems to track and identify causes of maternal mortality, and investments in historically Black colleges and universities (HBCUs) to research maternal health disparities.

Family Economic Security

The COVID-19 pandemic has put many Ohio families under immense pressure, including financial hardship. In March, President Joe Biden signed into law the American Rescue Plan Act (ARPA), which, among other provisions, included an expansion of the child tax credit. Under the expanded child tax credit, qualifying families receive $300 per month per child under the age of 6 and $250 per month per child ages 6 to 17. This expansion is credited with lifting millions of children out of poverty and decreasing food insecurity.

However, the expanded child tax credit is currently set to expire December 31, 2021. The Build Back Better Act extends the child tax credit expansion for another year, helping Ohio families with children afford things like housing, food, child care, and more.

In addition to extending the child tax credit, the Build Back Better Act includes investments in affordable housing, child nutrition, and more.


The U.S. Senate must act swiftly to pass the Build Back Better Act. This is a once-in-a-generation opportunity to make significant and long-lasting improvements to our early learning system, ensure more young children and their families have access to the health care they need, and boost families’ economic stability. Take action today through First Five Years Fund’s action center (click here) to send an email Senator Sherrod Brown and Senator Rob Portman expressing your support for the Building Back Better Act!


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