From Kaiser's 2020 survey on healthcare plans, the average worker contribution for HMO/PPO plans for a family was $5000-6000/yr [1]. These are not high deductible plans (those are specifically broken out) so they're going to be pretty good insurance, especially PPO. So $400/mo is only underestimating the true cost by about $100/mo. You can't use ACA marketplace prices to judge what your average worker is paying.

> spending $3k a month on day care

It costs $3200/mo to pay someone $20/h for 40 hours a week, in what world does day care (where one caretaker takes care of multiple children!) cost $3000/mo? The average cost of child care in California, which has _the_ highest cost of labor in the US, is $956/mo [2]. If you use the infant care cost it's $1400/mo, still nowhere near $3000. Maybe in the middle of New York City it costs $3000, but that's not a realistic living scenario for a plumber.

If your spouse makes $3000/mo then the rent increase (call it an extra $800/mo to get to $2k/mo) and childcare cost ($1000/mo) are more than covered by their extra income.

Please just look at the data and take a moment to understand what expenses outside of SF/NYC/LA look like.

[1]: https://www.kff.org/report-section/ehbs-2020-summary-of-find...

[2]: https://www.epi.org/child-care-costs-in-the-united-states/#/...