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Pre-K teacher Vera Csizmadia teaches 3- and 4-year-old students in her classroom at the Dr. Charles Smith Early Childhood Center in Palisades Park, New Jersey, in September.

Proponents also point to preschool as a boon for parents, particularly low-income parents. The opportunity to leave their children in the care of educators for a full day allows them to enter the workforce full time or pursue higher education. Washington, DC’s universal pre-K program helped lead to a 10 percentage-point increase in labor force participation for women with young children.

Forty-four states, DC, and Guam already funded some kind of preschool program during the 2019-20 school year, according to the National Institute for Early Education Research at Rutgers University. But most American kids under 5 weren’t enrolled in preschool that year: Only 34 percent of 4-year-olds and 6 percent of 3-year-olds were enrolled across the states that offer it. States spent more than $9 billion on preschool programs, spending $5,449 per child on average, that year.

“It used to be that 5-year-olds were on the margins of school entry — by the mid-1960s, only about half of states funded kindergarten,” Cascio said. “The progress has been much faster with pre-K, but there’s still a long way to go.”

Democrats’ six-year plan would offer free preschool to all 3- and 4-year-olds by sharing costs between states and the federal government to more than double the current number of preschool seats, offering slots to more than 6 million children. The bill would also require states to increase the salaries of preschool staff, establish new degree requirements for educators, develop new curricula for preschools, and regularly report progress to the Department of Health and Human Services.

But there are at least three major areas where the plan could fall short of its goal.

  1. Red states might refuse federal funds for universal pre-K

In a January poll of American adults from the nonpartisan First Five Years Fund, 73 percent of Republicans and 95 percent of Democrats were in favor of making free preschool more available to all 3- and 4-year-olds whose parents want to send them.

But the bipartisan support behind pre-K expansion doesn’t mean that all states, particularly red states, will sign up. Preschool programs have thrived in conservative states like Georgia and Oklahoma for years, but there’s no guarantee that Republican governors, who have traditionally left education up to local and state leaders, will want more involvement from the federal government.

“It’s the state’s responsibility to fund government education, not the federal government’s. Each community is different,” Sherri Ybarra, Idaho’s superintendent of public instruction, told the Wall Street Journal. “If I had the opportunity to sit down with President Biden, I would say, ‘Let the states focus on where they think their students need the most intervention and the most help.’”

Republican lawmakers in multiple states, including Missouri, Minnesota, North Carolina, and New Hampshire, told the Washington Post that they were wary of parts of the program, with some citing federal overreach as a concern.

“Republican leaders have supported federal investment in preschool historically. The way the program is set up, it is not the federal government getting inappropriately involved,” says Martin. “We want to partner with states, and the program anticipates that states would be the ones administering and setting standards for the program.”

The bill also contains a backup plan that allows the Department of Health and Human Services to partner with the local governments directly should states not opt in, allowing providers, from nonprofit organizations to schools and childcare centers, within the mixed-delivery system to receive funding.

  1. The money eventually disappears

From 2022 to 2024, the program would dole out money to the states based on population trends and child poverty rates — priority will be given to programs for children from families with income at or below 200 percent of the poverty line — setting aside $4 billion, $6 billion, and $8 billion for each year, respectively. Then in the next three years, from 2025 to 2027, a phase-down begins with the government picking up about 95 percent of state expenditures, down to about 63 percent in the final year. Year four of the program is the only year that government covers nearly all expected costs.

Chart: “The Build Back Better Act won’t cover all of states’ pre-K needs”

This shrinking pot of funds might turn some states away. As Matt Bruenig at the left-leaning think tank People’s Policy Project noted, the size of the program has only decreased with each iteration of the bill. In the first draft, the federal government covered 100 percent of state costs in the first three years and even picked up 60 percent of state costs in 2028.

Whether this shrunken federal contribution would be enough to entice states is left to be seen. One GOP lawmaker from Minnesota called the plan a “bait and switch,” since the money from the federal government decreases. Plus, the cost of establishing or expanding universal pre-K could vary widely from state to state: Some states may have extra space to house pre-K programs, for example, while others may need to build from scratch.

The first three years of the program will focus on pre-K expansion for children from low-income backgrounds, but some early education experts worry the targeted approach expires too soon.

States move to a universal free-for-all entitlement program in year four. But first, they have to ensure that “a majority of children” in high-needs communities have been offered the opportunity to enroll. The word “majority” could prove consequential, says Bruce Fuller, a sociologist and professor of education at the University of California Berkeley.

“If you look at states like the Dakotas or Montana, proportionately, they have huge populations of low-income and lower-middle-income class families who don’t have affordable pre-K,” said Fuller. “And how you fill that void in two to three years is going to be a pressing question.”

For many states, expanding pre-K is simply a matter of money. “The lack of funding has been a major impediment,” Cascio said. “States feeling constrained financially has been a major impediment to the expansion of these programs and meeting all children’s needs.”

And since almost all states already offer some form of free preschool, proponents of the Biden administration’s plan see federal funding as a continuation of state-level plans. “The funds are meant to supplement but not supplant dollars that states are already investing,” said Rasheed Malik, the director of early childhood policy at the Center for American Progress. “With this plan, it’s not possible to hit the pedal and go from zero to 60 right away. There’s sensitivity to the fact that states need to have a plan to make sure they’re not going to disrupt the supply of infant and toddler child care in communities.”

Federal spending increases in the first three years, with the expectation that it will take time for pre-K to be expanded into all communities in a state. Then in the final three years, the training wheels come off. “If a state government is forward-looking, they have to decide whether they’re going to be ready to ride the bike on their own,” Cascio said. “Are they going to have the state capacity and the fiscal capacity to do it on their own?”

Andrew Caballero-Reynolds/AFP via Getty Images
A Build Back Better sign is displayed in a pre-K classroom at East End Elementary School in North Plainfield, New Jersey, on October 25, when President Biden visited the school.

The six-year time frame also comes with the hope and expectation that the plan will be renewed and extended once leaders and constituents realize the benefits, though it’s clear that the amount of years is a result of political considerations as opposed to research that shows how long it would take to implement the program. It took decades to usher in kindergarten, and it’s still not compulsory across the country. But in states like Georgia and Oklahoma, the pre-K programs experienced dramatic year-on-year increases in pre-K enrollment when they rolled out their programs. “There is evidence to suggest that when a state is interested in doing this they can ramp up fairly quickly,” Cascio said.

  1. The guarantees on quality aren’t tough enough

Experts say that children from low-income families are best buoyed by high-quality pre-K, and studies show that low-quality pre-K could actually worsen outcomes for children of all circumstances.

But what “high quality” means is, in part, left to state governments to determine. To qualify for funding, if they do opt in, states will have to submit plans to the Department of Health and Human Services that estimate how much money they need to create and expand programs. States will also have certain requirements to receive the funding, like meeting quality thresholds that the states will define themselves, as long as the programs are not lower quality than Head Start.

But, some early education experts say, giving so much leeway to states could leave communities out.

“Who is defining need, and who is defining quality?” said Fantuzzo. “Do states have the capacity to understand where their preschool deserts are, and then will they have the time to get their act together to provide resources to those with the greatest need?”

The Biden administration says it wants to give states the room to develop and implement systems that work best for their population’s unique challenges and needs, and that all states will have to follow expansion strategies that are backed by research.

“The core of the approach to quality is that it gives flexibility for states to define the standards but requires them to do it based on evidence,” says Martin. “We have a fair amount of research that helps us understand what quality looks like. So states have to ensure that it’s being implemented.”

The proposal plans to press these quality provisions on states, but there’s no guarantee that states would reach high quality or distribute quality progressively, Fuller says.

Fuller’s examination of New York City’s pre-K expansion found that preschools mirrored the racial segregation of K-12 schools: Preschools serving mostly white or Asian families offered higher-quality environments than programs in the city’s Black and Latino neighborhoods since city leaders lost track of the distribution of quality.

A 2019 Education Trust study of 26 states and their preschool programs found that just 1 percent of Latino children and only 4 percent of Black children in those states were enrolled in high-quality preschool. Ultimately, Fuller fears that Biden’s blanket entitlement approach — extending free pre-K to well-off families — will cement an uneven playing field. (There’s some disagreement among experts here: Research Cascio conducted on Georgia and Oklahoma’s universal pre-K programs suggested that the presence of higher-income children may help to attract better teachers and improve quality for low-income children too.)

“States are not going to invent systems that meet the needs of the underserved. They’re just going to use what everyone else has already used, so they’re going to get the same results as before,” Fantuzzo said.

Matt Roth for the Washington Post via Getty Images
Children play together at Little Flowers Early Childhood and Development Center in Baltimore, Maryland, in January.

The program is better than the status quo, experts agree

Taken together with the child care investments proposed in the bill, most experts agree that the Build Back Better bill’s goals are a boon for children and families and beneficial for society at large.

“It’s important for folks to understand how inaccessible and inequitable the system is currently,” Malik said. “It is determined by a family’s income right now. Current childcare dollars that do go to preschools and care for younger kids and Head Start combined really can’t even serve 1/10th of the number of low-income kids who really need it.”

Over the decades, as the public has come to embrace the benefits of early childhood education, higher-income families have spent more money on private programs, only increasing opportunities gaps in education. Martin told Vox that universal pre-K would have big returns for state economies and is one of the best investments states can make for the country’s competitiveness, for children’s futures, and for parent choice.

“Once we get to the end of the six years we are going to get a lot closer to universality than we are now, and it will be really popular and remain a really high priority for legislators who have always shown a commitment to this issue in the abstract,” Malik said. “We’ll look back at this as a major turning point in early childhood education.”

Others aren’t as optimistic as Malik but share in his hope. “Pre-K too often inadvertently hardens inequities in children’s futures,” said Fuller. “We have a chance now to build a pre-K system that’s more progressive than the public schools, but it’s going be a massive experiment.”

Geography and socioeconomic characteristics are linked with whether people can actually find a doctor. Roughly 80 percent of rural America was considered to be medically underserved in a 2019 government analysis. People who live in urban centers also receive worse quality of care than people who live on the fringes of metro areas (i.e., suburbs), per a federal Agency for Healthcare Research and Quality report. Low-income Americans are less likely to have ready access to a primary care doctor than their wealthier peers.

The number of Americans with an established primary care doctor has been declining in recent years. At the same time, studies have found that people who do not have that kind of relationship with a physician develop more serious symptoms before they do seek care, which tends to lead to worse health outcomes. Their health problems are also more likely to persist if they don’t have a primary care doctor to follow up with after an acute emergency.

We have seen the importance of these established patient-physician relationships in the vaccination drive as well. Unvaccinated Americans have said in surveys that they are most likely to be persuaded by their personal doctor.

Risk factor No. 3: Equitable treatment

But having an insurance card and physically walking into a doctor’s office are only the first two steps to receiving effective treatment. Once there, a patient needs to be treated fairly by their doctor — the third risk, if they don’t receive that equitable treatment.

And, unfortunately, there is a growing body of evidence that, separate from insurance status and other variables, Black and Hispanic patients in America do not receive the same quality of care as their white counterparts. Health care providers are less likely to view their symptoms as serious and less likely to prescribe necessary medications to treat their illness. Already, Black and Hispanic Americans have experienced higher rates of death and hospitalization during the pandemic than their white peers.

“Given that people of color are less likely to have health coverage, are more likely to face barriers to accessing care, and receive poorer quality of care, they are likely to face disparities in obtaining care and treatment for Covid-19,” Samantha Artiga, director of the Racial Equity and Health Policy Program at the Kaiser Family Foundation, told me.

There is a racial component to the first two risk factors. Black and Hispanic Americans are more likely to be uninsured than white Americans. They are also less likely to have reliable access to medical care.

But race alone can determine whether or not an American receives appropriate medical care. Black and Hispanic Americans are more likely to say they’ve had negative experiences with a health care provider than white people, with higher shares reporting that their doctor did not believe them or that they were refused a test or treatment they thought they needed.

“Race is a factor, and I would say that it’s distinct from other barriers because it erodes care quality for patients of color directly and indirectly,” Kumi Smith, a University of Minnesota epidemiologist, told me. “Directly through implicit or explicit racial biases held by providers, indirectly through the racially disparate ways that societal resources and benefits are distributed across society. So in a way, patients of color, especially Black patients, suffer the consequences of racism twice over.”

According to multiple studies that have tried to look at the problem empirically, the discrimination that people of color describe in those surveys is real. Studies have shown that Black people are less likely than white people to be prescribed pain medications and are subjected to longer wait times in the emergency department.

New research looked at prescriptions for heart medications — the kind of routine care for serious but treatable illness that we hope Covid-19 antivirals will become — and once again found the same racial disparities, even when controlling for other factors such as insurance status.

The study, led by Utibe Essien at the University of Pittsburgh, examined patients with atrial fibrillation who were treated at the local Veterans Affairs hospital system. It found that Black and Hispanic patients were less likely to start taking medication for their condition. These patients were being treated at an integrated hospital system (eliminating the access issue) and the researchers focused on a subgroup of patients who enrolled in Medicare Part D to cover the cost of their care (eliminating the problem of uninsurance).

Yet disparities persisted in the treatment received by Black and Hispanic patients. Essien has written on this issue of “pharmacoequity,” which attempts to capture the full extent of the disadvantages that people of color face in receiving necessary medical care.

“Race is not just foundational to the challenges of underinsurance and access but access to treatments, from monoclonal antibodies to antiviral therapies,” he told me.

These inequities have been with us for a long time. They will continue to be with us in the future. And so long as Covid-19 continues to circulate, many Americans of color will face a higher risk from the virus as a result.

In the weeks since Peng’s initial disappearance, China’s response to the international outcry over her whereabouts and ability to speak freely has been alarmingly opaque. Among other steps, Chinese state media released a screenshot of an email supposedly written by Peng to Women’s Tennis Association President Steve Simon, which was meant to assure worried spectators that Peng was “fine” and “resting at home,” but did the opposite. Several dubious videos released by Chinese state media also failed to assure most of the international community that all was well.

Chinese tennis star Peng Shuai has sent an email to Steve Simon, the WTA Chairman & CEO, CGTN has learned. The email reads: pic.twitter.com/uLi6Zd2jDI

— CGTN (@CGTNOfficial) November 17, 2021

“These photos and videos can only prove that Peng Shuai is alive, but nothing else. They cannot prove that Peng Shuai is free,” Teng Biao, a prominent Chinese civil rights lawyer, told the New York Times last month.

High-profile figures have disappeared in China before

Although Peng’s disappearance sparked an international outcry, it’s far from the first time China has disappeared public figures. Fan Bingbing, one of China’s most famous actresses; Zhao Wei, a billionaire and actress; and Jack Ma, once China’s richest man and the head of massive e-commerce site Alibaba, have all disappeared for periods in recent years, only to reappear with little explanation.

Fan, a massive star who commanded China’s film industry and attracted international attention, was held under house arrest for four months in 2018 on charges of tax evasion — a fairly typical practice in China, as the New York Times reported the following year in a profile of the actress. She reappeared, cowed and praising “the [Communist] party and the state’s good policies.”

The disappearances of prominent people who the Chinese Communist Party, and President Xi Jinping in particular, perceive as fundamentally inimical to communist values — either through their outspokenness, as in the cases of Peng, artist Ai Weiwei, and actress Zhao; or their public image, like Ma and Fan — serves as a warning to Chinese citizens. In particular, criticizing the state, its policies, or prominent party members can be dangerous, as in the case of real estate tycoon Ren Zhiqiang, who disappeared last year and was later sentenced to 18 years in prison on corruption charges after criticizing Xi’s response to the Covid-19 pandemic.

Given that context, Peng’s disappearance and peculiar reappearance isn’t exactly a surprise; she is the first known person to publicly accuse a member of the Politburo Standing Committee — Zhang was once the vice premier under Xi, making him part of the highest rungs of power — of sexual assault. According to Lü Pin, a longtime Chinese feminist activist, the disappearance wasn’t so much a warning, but a panic response.

“Somehow, the Chinese government doesn’t know how to deal with her case,” Lü said. “They don’t have any language to talk about her case, so they have to block messages, they have to block everything because they don’t know how to deal with it in any other ways.”

The government censors China’s #MeToo movement

Even though Peng is an international figure, with two Grand Slam doubles titles under her belt and the adulation of the Chinese state because of her successful career, accusing a powerful party member of assault was a massive risk on her part — and seen as an unforgivable transgression against the state.

Her initial message on Weibo, which was quickly taken down, makes it clear she knew the danger of her decision to speak up: “It doesn’t matter if I’m hitting a rock with an egg, or being a moth that flies towards the flame,” she wrote. “I am telling the truth about what happened between us.”

According to a recent piece in Australian outlet The Conversation, “[Peng’s] story directly contradicted the Communist Party’s official narrative of harmonious relations between people and Party. In particular, her allegations contradict the narrative that women, who purportedly ‘hold up half the sky in China,’ enjoy gender equality under this government.”

That narrative, however, isn’t the reality in China. As Leta Hong Fincher, author of Betraying Big Brother: The Feminist Awakening in China, argued in a Washington Post piece in 2018, far from guaranteeing gender equality, Xi’s authoritarian regime in fact depends on enforcing patriarchal norms and depicts him as the head of the “family” that is the nation.

That’s only gotten worse as China’s economic boom of the past several decades slows. According to Hong Fincher, “Chinese propaganda under Xi’s leadership has revived sexist elements of Confucianism, in particular trying to push the notion that a traditional family (based on marriage between a man and a virtuous, obedient woman) is the foundation of a stable government.”

Given that framework, Peng’s decision to speak publicly against the state, pierces the illusion of a harmonious “family” headed by “Xi Dada” — Big Daddy Xi — and exposes devastating family secrets.

“Peng Shuai’s disclosure of being sexually abused by Zhang Gaoli, the former Vice Premiere of the People’s Republic of China, is crucial,” Lü wrote in a November blog post. “Though only the tip of the iceberg, it exposes the real life of Chinese highest cadres, on how their power masked their hypocrisy, and how they are excessively corrupted.”

“Every day, there are victims trying to get attention, but most of them cannot get any attention, and they were censored before people can see them,” Lü said in a phone call with Vox. “That’s sad, but only very few people’s voices could be heard in China, could go beyond the censorship.”

Despite a handful of high-profile punishments for sexual assault, there is a limit to how far the Communist Party will go in allowing a Western-style #MeToo movement to take hold; previously, China has censored the #MeToo hashtag on social media and detained journalist Sophia Huang Xueqin, who has been deeply involved with the #MeToo movement in China, on a charge of “inciting subversion of state power.”

In China, according to CNN, state outlets publish articles saying sexual assault isn’t a problem, despite evidence to the contrary. Only about 43,000 cases of “crimes against women’s rights” were prosecuted between 2013 and 2017, in a nation of 1.4 billion. And Peng’s censorship indicates that, like many Chinese women without her star power, she’ll be unable to tell her story and the accused won’t face justice.

“I doubt that the Chinese government will investigate her accusations,” Lü told Vox over the phone. But, she said, Peng’s case shows the world “the reality of [Chinese] politics”: Though some politicians have been punished by the state for having “affairs,” Lü said, “they never expose the women’s name, and what’s the real experience for them. Were those women raped? Nobody knows.”

The world responds to China’s continuing clampdown

Peng’s accusation came just as Xi tightens his grip on power; a resolution on the “correct view” of the Communist Party’s history, passed last month, calls on “the entire party, the entire army and people of all ethnic groups to unite more closely around the Party Central Committee with Comrade Xi Jinping as the core,” according to Agence France-Presse, quoting Chinese state media outlet Xinhua.

The new resolution centers Xi as the ultimate arbiter of Chinese political culture, the state, and the history of China’s Communist Party — elevating him to the level of previous Chinese leaders Mao Zedong and Deng Xiaoping — and attempts to justify his crackdowns on pro-democracy activists, Uyghur minorities, and other perceived adversaries.

In addition to Xi’s own power play, the February Beijing Winter Olympics will give China an opportunity to show its power and wealth on a global stage, portraying the Communist Party as a viable alternative to American democracy, Atlantic Council fellow Michael Schuman writes in the Atlantic.

But Peng’s case throws a wrench in that plan.

While the Olympics will probably go off as planned despite a potential US diplomatic boycott over China’s human rights atrocities, the International Olympic Committee’s response to Peng’s disappearance has heightened scrutiny of the Games and the IOC itself.

In a statement this month from Human Rights Watch, Andrea Florence, the acting director of the Sport & Rights Alliance, criticized “the IOC’s eagerness to ignore the voice of an Olympian who may be in danger and to support claims of state-sponsored media in China.” In a recently introduced congressional resolution, two US lawmakers have also accused the IOC of “collaborating with the Communist Party” in covering up Peng’s accusations and disappearance.

“The IOC has demonstrated yet again it cares more about appeasing the Chinese Communist Party and the Olympics’ corporate sponsors rather than the wellbeing of Olympic tennis star Peng Shuai who accused a top CCP official of sexual assault,” Rep. Michael Waltz (R-FL) said in a statement announcing the resolution condemning the IOC’s actions.

The IOC’s response stands in stark contrast to that of the WTA, which unequivocally suspended a lucrative, decade-long contract to hold professional tournaments in China earlier this month.

BREAKING: WTA announces decision to suspend its tournaments in China due to the ongoing Peng Shuai situation.

From Steve Simon: pic.twitter.com/dKpGZYPbzh

— Ben Rothenberg (@BenRothenberg) December 1, 2021

“While we now know where Peng is, I have serious doubts that she is free, safe and not subject to censorship, coercion, and intimidation,” Steve Simon, the WTA president, wrote in a statement announcing the suspension. “If powerful people can suppress the voices of women and sweep allegations of sexual assault under the rug, then the basis on which the WTA was founded — equality for women — would suffer an immense setback.”

With such sustained attention on the problem, it’s unclear how long China can keep up the ruse that Peng is fine and able to speak without censorship.

But while Peng’s case highlights a multitude of serious problems in Chinese politics and culture, Lü told Vox, it likely won’t change the political structure.

“It’s extremely hard. Our government is very much powerful; nobody really creates real crisis to them,” she said. ”I think that’s the truth, we should admit that. Even Biden cannot do anything.”

But expecting a case like Peng Shuai’s, explosive as it is, to create systemic change in China, Lü said, is missing the point of the feminist movement. “Our vision is not to overturn the rule of the Chinese government,” she said. “Our goal is to just make women not suffer so much.”

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