Build Back Better has gaps in child care funding

Group of kids playing with constructor

The pandemic has exposed many inequities in American life. Access to affordable child care is chief among them. 

Nearly one in five working parents surveyed in 2020 had to leave work or reduce their work hours due to a lack of child care, and almost two-thirds said they had no backup child care whatsoever. Women between the ages of 25 and 44 were three times more likely than men to quit their job due to pandemic-related child care needs. Low-income families of color have been hardest hit. 

Kelley Murphy

Fortunately, Congress is nearing an agreement on child care and universal preschool provisions as part of the Build Back Better Act, which includes $400 billion for child care programs. While we strongly support this once-in-a-generation investment, there are significant issues that – unless corrected – will leave many Arizona families behind and have significant economic and workforce implications.    

As currently drafted, the legislation calls for these child care funds to flow through two programs – one for children under the age of 5 and another for children ages 3-5. But there’s a catch: states will only receive funding if they opt in to one or both programs. Although the program provides a generous 95% federal match to participating states, dozens of states may opt out for political or budgetary reasons. 

If Arizona fails to opt in, countless families will be unable to afford child care. That’s why it’s critical the program be structured in a way that encourages states to participate and provides sufficient funding by other means in states that don’t – namely, by increasing child care dollars available directly to local governments and extending the Child and Dependent Care Tax Credit.  

Kylie Barber

The current version of the Build Back Better Act only includes $1 billion in child care aid for localities, and has excised the tax credit provision entirely. Without it, if Arizona doesn’t opt in to accept federal assistance, a family of four earning between $65,000-$125,000/year could spend as much as one-third of their income on child care alone. 

Fully funding the Child and Dependent Care Tax Credit is essential to enabling women to rejoin the U.S. labor force, where their participation rate has fallen to its lowest level since 1988. 

As leaders of Children’s Action Alliance and the Arizona Early Childhood Alliance, we know the early years of a child’s life are most critical in their development. There is no better investment our society can make. 

While we commend President Biden and Congress for making early childhood care and education a priority in the Build Back Better Act, the legislation includes critical gaps that may leave too many Arizona families behind and our economy hobbled. We urge Sens. Kyrsten Sinema, Mark Kelly and Arizona’s entire congressional delegation to address these issues, which will go a long way toward making child care more affordable for all. 

Kylie Barber is alliance coordinator for the Arizona Early Childhood Alliance; and Kelley Murphy is vice president of policy for Children’s Action Alliance. 

Congress: Lower the cost of prescription drugs

Drug prices have increased tremendously over the last several decades. These price increases have affected a wide range of drugs, impacting nearly all Americans who rely on prescription medications to maintain their health. This increase in the prices of drugs in the U.S. represents one of the major threats to the health of the population, economic growth, and trade flows. This is not new information, of course. But what is novel is that the U.S. government is finally poised to do something about it – so long as Congress agrees to it. 

 On November 19, the U.S. House passed President Biden’s Build Back Better Act, which includes a crucial provision that would allow the federal government to negotiate drug prices through its Medicare program. This provision must remain in the Senate’s version of the bill if we are to finally reign in the astronomical cost of prescription drugs in this country. 

Heart disease, cancer, and diabetes, are major causes of death in the U.S., yet drugs for these conditions have become increasingly expensive. Because of this surge in drug prices, patients take fewer tablets to save money, worsening health outcomes. And for the millions of Americans without health insurance, higher prices hit especially hard, disproportionately harming the poorest patients. 

Bashar Malkawi

In this context, the Build Back Better Act plays an important role in the debate over drug prices. It’s prime time for the U.S., a leader and shining torch for other countries, to move forward with a health system that works for all, including with affordable drug prices. 

In terms of the actual provisions incorporated in the bill, it is fair to say that the bill is a win-win for all parties involved. It allows the federal government to negotiate prices for some high-cost drugs covered under Medicare Part B and Part D. This would result in lower prices of high-cost drugs without generic competition. 

The new plan would be phased in, targeting the highest price medications that lack competition. More specifically, negotiations over prices would only involve 10 drugs in 2025, 15 drugs in 2026 and 2027, and 20 drugs in 2028 for single-source brand-name drugs that lack generic competition. These drugs would be selected from among the 50 drugs with the highest total Medicare spending.   

In addition, Build Back Better exempts from negotiations for nine years any small-molecule drugs and for 13 years any biological products, starting on their FDA-approval date. Arizona Senator Kyrsten Sinema helped secure this language, which should allay concerns by pharmaceutical companies that the popular prescription drug negotiation measures will hurt incentives for research and development. In sum, Build Back Better is a well-balanced bill that incorporates rules that protect the interests of both the public and drug companies at the same time.   

 It is critical that the final bill retains at least the basic provisions of prescription drug reform included in the House-passed version: Medicare negotiation, inflation rebates, and caps on out-of-pocket drug spending and cost sharing for insulin and adult vaccines. It is high time for the U.S. Senate to get its act together and approve these meaningful and commonsense ways to lower the cost of prescription drugs and put the interests of patients first. 

Bashar Malkawi is global professor of practice in law at the University of Arizona.   


Sinema must support clean energy investments in Build Back Better Act

In this June 22, 2021, file photo, Sen. Kyrsten Sinema, D-Ariz., leaves a closed-door bipartisan infrastructure meeting with a group of senators and White House aides on Capitol Hill in Washington. (AP Photo/Manuel Balce Ceneta)

Congress is now debating legislation that could unleash $115 billion in new investments for Arizona, securing our state’s position as a national leader in clean energy innovation and ensuring a growing economy for generations of Arizonans to come. But none of this will happen if Sen. Kyrsten Sinema doesn’t support strong clean energy investments in the Build Back Better Act.  

The Build Back Better Act is a comprehensive plan to expand our clean energy economy and create millions of new jobs, providing a path to prosperity for decades to come. Key to these achievements are provisions that would accelerate utilities’ transitioning to clean energy through expanded tax credits and other incentives. With Arizona’s endless sunshine, these incentives would supercharge our solar and battery industries, spur clean technology innovation and create jobs. We need Sinema to deliver for our state.  

Though she expresses concern about the size of the Build Back Better Act, clean electricity policies represent only about 10% of the plan’s price tag. But the plan’s gains far exceed its costs: Non-partisan think tank Energy Innovation estimates federal policies that reach for 80% clean electricity across the U.S. would create nearly $40 billion in solar, wind and battery projects in Arizona alone. And the Seidman Research Institute found adopting the full Build Back Better Act would pump $115.6 billion into our economy.  

Right now, almost half of Arizona’s electricity comes from natural gas. Gas prices are currently spiking and will remain volatile while technological innovation is continuing to drive down solar, wind, and battery prices. Meanwhile, Salt River Project is expanding the Coolidge gas plant to the tune of $1 billion, despite strong opposition from its customers. This makes no sense in a state with America’s best solar resources. Businesses and hard-working families demand better.  

Our solar industry’s growth is being suppressed by an uncertain policy environment as the Arizona Corporation Commission flip-flops on clean energy rules for the state. But if Sinema votes for these investments, it would be a boon to our solar industry and make utility net-zero goals achievable even sooner than 2050. This would not only create enormous opportunities to build and export solar energy to bordering states with high clean energy demand, but also spur economic development and cement our position as a national solar leader.  

Billions in new investment also mean new, good-paying jobs. Lots of them. The Energy Innovation research shows accelerating the pace of clean electricity in the U.S. would support 500,000 to 1 million new jobs per year nationally through 2030, and the Seidman analysis shows Build Back Better as a whole would create 100,000 jobs in Arizona every single year. Additionally, federal investment dollars could be used for worker retention and for clean energy projects in Navajo and Hopi communities still hurting from the closures of the Navajo Generating Station and Kayenta Mine.   

Arizona is particularly vulnerable to the impacts of climate change with two of the fastest-warming cities in the country and unprecedented drought. Heat-related deaths doubled this year and approximately 200,000 Arizonans are at risk of heat stress.  

Sinema has said climate solutions are priorities for her, and we Arizonans agree. Seventy percent of Arizona voters want the government to do more to solve climate change and 70% support specific programs that would incentivize our utilities to produce more clean electricity every year. Federal investments in clean energy would deliver emissions reductions scientists say are necessary to avoid the worst consequences of climate change. Without strong clean energy provisions in the Build Back Better Act, it will be much harder to transition in time.  

Sinema campaigned on a pledge to work hard every day to deliver for Arizona families. By leveraging her position as a key vote in the Senate, now is her chance to guarantee decades of economic prosperity and sustainable, good-paying jobs for all residents in the state. Senator Sinema, all eyes are on you to lead our state and our country at this critical moment. 

Steven G. Zylstra is president and CEO of Arizona Technology Council.