With 65 percent of children under age six having all of their parents in the labor force, most families with young children require some form of nonparental early child care. Considering trends in the familial division of labor, family structure, and the composition of the labor force, reliance on early child care will likely increase. For the most part, contemporary policies and the modern economy necessitate that all parents work and yet, early child care is not part of the workforce infrastructure. Relative to comparable developed nations with more supportive family policies-such as paid family leave, protections for demanding a change to part-time work schedules, and publicly provided child care services-the labor force participation rate of women in the United States has fallen behind, coming in between 2 and 14 percentage points lower than 19 other developed nations in 2016. Evidence shows that in the United States, options for licensed early child care have been persistently deficient in meeting the needs of working parents. Despite successful experiments with nearly universal care and multiple attempts at passing legislation in support of comprehensive universal early child care in the United States, there has been little progress in addressing the need for high-quality early child care to support working parents. The purpose of this paper is to develop a collective understanding of the shortcomings of licensed early child care in the United States, to lay out the challenges for meaningful reform, and to convey the need to make high-quality early child care accessible to all working parents of children under age five, with special consideration of low- and moderate-income parents in New England. The paper also provides a glimpse of historical efforts to enable parents to work by addressing child care needs, shares elements of a proposed research agenda, and offers a high-level perspective on a possible pathway to change. The main components of this paper are the following: 1. An overview of the U.S. early child care market on dimensions of quality, affordability, and availability 2. A review of the literature on the effects of child care access on labor force participation and employment outcomes 3. Historical analysis of the early child care arena and successes and failures of reform attempts 4. Research on the effects of early child care on the economic and employment advancement of working parents 5. A possible pathway to change (author abstract)