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Although “the family” has been a recurring theme in American political discourse, little has been done to help families cope with the tremendous challenges they have been faced with over the past three decades. This paper analyzes the historical reasons for the absence of a national child care policy in the US and offers an overview of public programs. The issue has gained prominence lately and has generated a growing interest at the federal and state levels. However, in spite of increased government funding, there are recurring issues of cost, quality and access in a highly fragmented system, with huge disparities from state to state. The problems have been exacerbated by the 1996 reform, which aims at putting most welfare mothers back to work. The situation is likely to worsen with the cuts in social welfare programs projected for 2003.