Protesters in Washington DC call for Sen. Manchin to support the full Build Back Better Bill. Photo: Phil Pasquini/Shutterstock

Senate Democrats’ apparent inability to pass President Biden’s $2 trillion social spending and climate bill – the Build Back Better plan – is a massive blow to the middle class and the environment. But the continued failure to pass federally mandated paid family leave and to extend the enhanced child tax credit are especially catastrophic for poor families and their children.

Unless a compromise is reached, Democratic West Virginia Sen. Joe Manchin’s continued insistence that he will vote no on the plan makes it all but impossible for Biden to get this bill – the centerpiece of his economic agenda – passed. That’s the effect of Manchin’s holdout in a 50-50 Senate, with no Republicans willing to break party lines.

Paid family leave has been associated with a 13% reduction in infant mortality – yet the U.S. is the only member of the 41-nation Organization of Economic Cooperation and Development that does not guarantee it. Although federal workers receive 12 weeks paid leave, only 25% of private sector workers get it, according to a 2019 survey. Many workers do not receive any paid leave, especially hourly workers and those in lower-wage industries.

As a mental health clinician, I have seen how parents’ inability to take time off from work to care for a newborn can take a severe toll on infants, children and their families. For lower-income parents, paid leave is generally not an option, nor is licensed child care, which costs on average $16,000 per year for infants. This leaves low-income parents with limited choices, fueling exhaustion, depression, domestic violence and worse. Even the best-intentioned parents can’t help but pass their stress and trauma onto their children, sowing the seeds of personality and behavior patterns that can last generations.

Take the story of one of my patients. Like one in seven new mothers, she was exhibiting signs of postpartum depression after the birth of her son and could barely get out of bed. Although she needed to work to support her baby, her depression and deep fear that something awful would happen to her son if she left him with a neighbor almost got her fired.

Through psychotherapy, she realized her deep-seated anxiety was rooted in her past: When she was 6 years old, she had been molested by a neighbor’s relative when her single mother had to leave her and her infant brother with the neighbor in order to go to work. The realization of how her current situation mirrored her past improved her depression. Although she could have become depressed without these experiences, her history of trauma compounded things, threatening her ability to provide for the next generation. Paid family leave could have prevented, or at least eased, her situation, as well as that of her mother’s before her.

But the apparent demise of Build Back Better doesn’t just prevent many parents from staying home to take care of their children. The plan also carried within it the extension of the enhanced child tax credit and a plan to broaden access to childcare and universal pre-K for kids 3 and 4 years old. These too will be gone if the bill dies.

Children are the poorest age group in the country. In 2019, over 10 million American children lived in poverty, 71% of whom are children of color. Almost half of America’s poor children live in extreme poverty, in families with an annual income below $25,000. In California, where I live, the situation is similar. Data from 2018 found that 18.8% of California children live in poverty. And all of this was before COVID.

That’s why in March, Congress passed the American Rescue Act, which increased the previous child tax credit benefit from $2,000 to $3,000 with a $600 bonus for children younger than 6 for the 2021 tax year. It also established monthly payments of $300 per child under the age of 6 and $250 for those 6 to 17 years old. Without an extension, these enhancements will expire in early 2022.

Contrary to Sen. Manchin’s concerns that parents would use their child tax credits on drugs, 78% of parents in a recent survey reported using their payments to help with housing, utilities, food costs and activities for kids. Moreover, according to an August survey by the Census Bureau, the tax credit allowed 3.3 million more households to feed their children, and a September report found that 94% of parents are doing the same amount of work or more due to the tax credit. If the Build Back Better plan were to pass, the current credit would be extended until 2025, reducing child poverty by 40% in a typical year.

According to Columbia University’s Center on Poverty and Social Policy, improving children’s lives now will save American taxpayers hundreds of billions every year — by reducing infant mortality and other health care costs, lowering crime rates, improving public safety and cutting expenditures on protective services for abused and neglected children. Future generations will benefit as these savings grow and, when today’s children become tomorrow’s workforce, will contribute to everyone’s well-being by expanding the tax base.

Helping children and their families is an investment, not welfare. It improves short- and long-term health, shrinks health care costs, reduces crime, and raises kids’ school performance and adult pay. Infants and young children are the most vulnerable of all age groups, so infants can’t wait. There’s no reason that they should.

Stephen Seligman is on the faculties of the University of California, San Francisco and the New York University Postdoctoral Program in Psychotherapy and Psychoanalysis. A version of this commentary was first published by the San Francisco Chronicle.

Stephen Seligman, DMH

Stephen Seligman, DMH, is on the faculties of the University of California, San Francisco and the New York University Postdoctoral Program in Psychotherapy and Psychoanalysis.