This study aims to help policymakers understand the implications of the HBCC decline, and hence better understand how to support and regulate the child care market to reduce barriers to ECE access, particularly for families and children most in need of services. Specifically, since families are the direct and ultimate consumers of early care and education, this study aims to examine how families’ perceptions of ECE access changed as the number of HBCCs sharply declined. OPRE’s framework defines ECE access as a multidimensional construct that involves reasonable effort to locate and enroll a child in an ECE arrangement that is affordable, supports the child’s development, and meets parents’ needs.