American entitlement programs are designed to support workers and provide only limited coverage for spouses who are not full-time workers themselves. For instance, stay-at-home parents do not receive credits toward a work history, leaving them with a lower “spousal” benefit at retirement or “widow(er)” benefit if the spouse with a work history dies. When retiring workers become eligible to receive Medicare, spouses will typically lose their employer-based family coverage but may not yet be eligible for Medicare themselves. The SSDI disability program is available only for people with a recent work history, even though a stay-at-home parent who becomes disabled could create challenges and costs for a family comparable to those faced if the working parent becomes disabled. The Affordable Care Act’s “Family Glitch” makes a worker eligible for a subsidized health insurance plan if the worker’s own employer-based coverage is too expensive but offers no help if the employer provides affordable coverage for the worker alone and not for dependents.

The United States should reform its social insurance programs to recognize the family as the relevant economic unit for purposes of calculating eligibility and benefits. Parents should both receive credit for work when one is working and the other is caring for children, and the affordability of health insurance should be defined based on the cost of family coverage. Finally, Congress should create a “Family Retirement Account” similar to an IRA or 401(k) that allows parents to save together toward retirement, make annual contributions equal to twice the level allowed in individual accounts, and receive employer contributions on behalf of them both.