Countering the mainstream

The Biden American Jobs Plan Is Also a Health Plan

by | Jun 9, 2021 | The Edge, Commentary, News

In “Having and Being Had,” her groundbreaking book on capitalism, consumption, and our own participation in the system, Eula Biss reaches back into the archives to define the word precarious – “depending on the will or pleasure of another.” But just who joins the precariat? “Everybody, actually,” is what economist Guy Standing would say, if we consider everybody to mean possibly anybody. Biss explains: “Illness or disability can force someone into the precariat, as can divorce, war, or natural disaster. The precariat is composed of migrant workers and temp workers and contract workers and part-time workers. People who work unstable jobs that offer ‘no sense of career.’”

The COVID-19 pandemic, the climate change emergency, and the decline of unions have expanded precarity’s reach. A job forecast created by TrueBlue and Emsi in 2019 found that temporary jobs will grow at a faster rate than jobs overall through 2025. The report also showed that workers ages 35 and older make up the largest percentage of temporary workers, with twenty percent being 55 or older. Many people who we assume are employees of the companies who clean our offices, deliver our packages, and staff the hotels we visit are actually subcontractors without pathways to fair wages, safe work environments, and opportunities for advancement. This is happening up and down the income scale but is particularly prevalent in low-wage work. This fissuring of the workplace, as David Weil calls it, is a fundamental shift in the nature of jobs. It has huge health care implications. Not only are temporary workers less likely to have access to health insurance, but sometimes they fall through the cracks of the laws that are meant to protect them. In “The Fissured Workplace,” David Weil reminds us that “traditional approaches to enforcing those [health and safety] laws similarly ignore the myriad new relationships that lie below the surface of the workplace. As a result, the laws crafted to safeguard basic standards, to reduce health and safety risks, and to cushion displacement from injury or economic downturn often fail to do so.”

Even though it technically ended in June 2009, the lessons from the last large global recession, the Great Recession of 2008-2009, are still relevant today. In fact, many people are still feeling its aftereffects, more than a decade later, even before the COVID-19 recession started. According to a 2019 Bankrate poll, almost half of adults during the Great Recession have seen their wages stagnate since and more than a third of those who lost their jobs during the Great Recession have seen their pay drop.

COVID-19 had an even more drastic effect on the employment and economic well-being of American households. According to the Board of Governors of the Federal Reserve’s Report on the Economic Wellbeing of U.S. Households published in May 2020, “thirteen percent of adults, representing 20 percent of people who had been working in February, reported that they lost a job or were furloughed in March or the beginning of April 2020 … These job losses were most severe among workers with lower incomes. Thirty-nine percent of people working in February with a household income below $40,000 reported a job loss in March.” Most of this hardship has landed at the feet of women, particularly women of color. In the first 10 months of the COVID-19 pandemic, women had a net loss of 5.4 million jobs – 1 million more than jobs lost by men. In December 2020 alone, 154,000 Black women dropped out of the labor force. The COVID-19 pandemic has put a spotlight on the caregiving crisis in the United States. The sociologist Jessica Calarco said, “Other countries have social safety nets. The U.S. has women.”

Biden’s American Jobs Plan of 2021 will help lessen this precarity. Unveiled on March 31, 2021, this plan will invest about $2 trillion over the next decade to upgrade and bolster infrastructure, improve supply chains, invest in science and research, and invest in care infrastructure. Some commentators have highlighted that this jobs plan is a climate plan, too, since strengthening infrastructure “prevent(s), reduce(s), and withstand(s) the impacts of the climate crisis.” But I would like to focus on how the American Jobs Plan is also a health care plan. Both in direct and indirect ways, this plan will improve the nation’s health, particularly that of low-wage workers, women, and anyone affected by the care economy.

One main way that this plan will improve health care and health of Americans is through lessening the precarious nature of the care economy. America is in a caregiving crisis. Families are struggling to care for children, elderly relatives, and relatives with disabilities. This affects financial resources, time, and mental health, with women bearing most of the burden. COVID-19 took this crisis to another level and forced many women to leave the labor force to tend to their families. The American Jobs Plan will “expand access to home and community-based services (HCBS) and extend the longstanding Money Follows the Person program that supports innovations in the delivery of long-term care,” which expands Medicaid and allow more people to be cared for at home.

Essential home care workers populate one of the industries where temporary and gig work is common. The majority of the workers in this industry are women of color and their labor has been undervalued and underpaid. About one in six of these workers are in poverty. This plan creates more of these jobs through the HCBS expansion but also raises their wages and benefits and ensures “workers have a free and fair choice to organize, join a union, and bargain collectively with their employers.” This will improve the livelihoods and health of the workers themselves, but also their patients. A study by the Washington Center for Equitable Growth found that increased pay for workers led to fewer deaths and fewer health violations.

Other ways that this plan will enhance the health of Americans is by strengthening the infrastructure needed to be able to actually accept and travel to a safe and well-paying job with benefits – namely, public transit and childcare. Reliable public transit is an important factor in the health of a population. Public transportation infrastructure is not only in great need of repair, but these needs are inequitable. Some neighborhoods are totally cut off from public transportation, which limits the type of work their residents can do or makes communities dependent on cars. The Biden American Jobs Plan states that “the Department of Transportation estimates a repair backlog of over $105 billion, representing more than 24,000 buses, 5,000 rail cars, 200 stations, and thousands of miles of track, signals, and power systems in need of replacement.” Investing in this infrastructure will address racial equity, environmental justice, and expand job stability and opportunities in a more inclusive way.

Adequate childcare allows for better jobs for parents and more stability and health for children. This plan aims to update facilities and bring more facilities to high-need areas. When childcare options don’t exist, it limits or even completely eradicates parental workforce participation. This, unsurprisingly, affects women much more than men. President Biden is calling for an expanded tax credit to encourage employers to create childcare centers at their workplaces. This will have positive implications for stable employment, but also will have positive spillovers on child health and parent mental health.

In “Having and Being Had,” Eula Biss says, “We shouldn’t ask our rich to be good… we should ask our economic system to be better.” Biden’s American Jobs Plan is a good first step in this direction.



Eula Biss, Having and Being Had, 2020, Penguin Publishing Group.


Board of Governors of the Federal Reserve System, “Report on the Economic Well-being of U.S. Households in 2019, Featuring Supplemental Data from April 2020,”


Diana Boesch and Shilpa Phadke, “When Women Lose All the Jobs: Essential Actions for a Gender-equitable Recovery,” February 1, 2021,


Business Wire, “Temporary Employment in the U.S. to Grow Faster than All Jobs through 2025, According to a New Job Forecast from TrueBlue and Emsi,” November 1, 2019,


Annie Nova, “Many Americans Say Their Financial Situation is Worse Since the Great Recession,”


Anne Helen Petersen, “‘Other Countries Have Social Safety Nets. The U.S. Has Women,’” Culture Study, November 11, 2020,   
Krista Ruffini, 2020, “Worker Earnings, Service Quality, and Firm Profitability: Evidence from Nursing Homes and Minimum Wage Reforms,” Washington Center for Equitable Growth Working Paper Series, workingpaper-coversheet- template (


David Walker, 2021. “Biden’s American Jobs Plan is Smart Climate Policy. Here’s Why,”


David Weil. 2014. The Fissured Workplace: Why Work Became So Bad For So Many and What Can Be Done to Improve It. Harvard University Press.


The White House, “Fact Sheet: The American Jobs Plan,” March 31, 2021,


Photo by Evan Vucci, AP Photo

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