Will America’s Care Crisis Take Center Stage on the 2024 Ballot?

Article In The Thread
Father with his child entering a voting center on presidential election day.
Rob Crandall / Shutterstock.com
Jan. 18, 2024

With the presidential election year fully underway, we’ve already heard so much about what will likely be defining issues for voters. But will we hear much about care? With 10,000 baby boomers turning 65 every day facing an underfunded elder care system, and a child care industry in dire collapse, our weak care infrastructure touches the lives of millions of voters in highly personal ways every day.

After researching the efforts of a burgeoning care movement for my report, A Playbook to Transform How America Cares, I believe care issues around child care, elder care, disability care, and paid family leave may play a bigger role than ever this election cycle.

A 2023 poll conducted by the First Five Years Fund found that nearly 80 percent of voters from across the political spectrum support more federal funding for child care. And according to a new poll by Lake Research Partners, 85 percent of voters in battleground states support paid family and medical leave. Ballot initiatives at the state and local level for funding children’s services are passing at a strong rate in red and blue states, and are perhaps one of the most effective ways to address the child care cliff in the face of inaction from Congress.

Care advocates aren’t relying on popularity alone to ensure America gets meaningful federal funding in the future. They are amassing power and influence by ramping up political spending to push for a seat at the table for the opportunity to advance social legislation.

The Biden administration’s Build Back Better (BBB) social agenda brought care to the forefront, and, if it passed, would have transformed our care infrastructure with universal child care, paid family leave, and funding for in-home and community-based services. But despite this setback, care advocates have made great progress even with limited financial resources — a big success story that deserves more attention.

After BBB’s social agenda failed, and the climate-focused Inflation Reduction Act (IRA) passed in its wake, Kristin Rowe-Finkbeiner, CEO of MomsRising, asked, “What’s the difference between the climate change movement and the care movement? Tens of million dollars and several decades [of concerted organizing]. I bring that up not to be bitter, but to show how much we were able to accomplish relative to the environmental movement with less time and less money. That shows true momentum for these care policies.”

This momentum is also evident in the popularity of care policies when they are put directly to voters on ballot initiatives. There are over 50 voter-approved children’s funds across the country that generate $1.5 billion annually for programs for kids outside of K-12 education. They have passed in red and blue states, showcasing their appeal beyond partisan divisions. In 2022, New Orleans was able to unlock $40 million annually through a combination of a property tax ballot initiative and state matching funds for early childhood education for 2,000 low-income students with bi-partisan support. Escambia County in the Florida panhandle passed their voter-approved children’s fund in 2020 with 61 percent of the vote at the same time that Donald Trump won the area with 57 percent of the vote.

Advocates have been able to make this happen with relatively small budgets. “The next frontier is just going to be getting more private donors to resource these ballot initiatives to make a big impact,” said Elizabeth Gaines, the CEO of Children’s Funding Project, describing how she sees the strategy evolving. “The folks that fund our (c)(4), we help them achieve an amazing [return on investment]. If they put $80,000 into [supporting a care funding ballot initiative], and passing that then allocates $30 million a year in perpetuity for kids — it’s a pretty good return on investment.”

Despite the popularity of care with voters, care’s lobbying efforts lag far behind other causes. Data from Open Secrets shows what the three highest-spending care-oriented groups spent on lobbying in 2021 and 2022 versus what the three highest-spending environmental groups spent during the same time. The top three environmental lobbying groups outspent care lobbying groups about three to one.

Graph showing the top three spenders in care vs. environmental lobbying spending

The social component of Build Back Better faced fierce resistance from business groups largely because they opposed any hikes in corporate taxes, which was the proposed funding source for the measure. While these business groups lobbied on a range of issues in 2021 and 2022, not just BBB and the IRA, the differences in spending between these influential groups with decades of lobbying experience and established connections compared to newly lobbying care groups is stark. The top three care groups had 1.4 percent of the lobbying spend compared to top business groups who opposed BBB.

Based on lessons learned, care movement leaders refuse to be politically sidelined again. Here are some of their upcoming political plans and what to watch for in 2024:

While these political investments are the largest ever made by care groups, they are still dwarfed by what is typically spent in presidential election cycles. The 2020 election was the most expensive on record, with $14.4 billion spent, and there are no signs of spending slowing down in 2024. In addition to raising political funds, the care movement is activating labor unions, direct care workers, and those who receive care to move the needle on the issue this election year — from mobilizing voters to elevating stories from the frontlines of the care crisis to inspire action. Can the care movement build itself up as a powerful political constituency in 2024? As the race heats up, I will be watching to see if care will take center stage as a policy issue in the U.S. presidential election. My hope is, it will.

You May Also Like

A Playbook to Transform How America Cares (Better Life Lab, 2023): Tactics for how policymakers, care workers, consumers, activists, philanthropists, media, and business leaders can grow a “care movement.”

Fixing the U.S. Child Care Crisis Starts with Investing in Care Journalism (The Thread, 2023): By supporting independent writers and content creators, the Better Life Lab played a crucial role in keeping the child care crisis, the narrative that care is vital infrastructure, and the need for solutions at the forefront of the national conversation.

Health, Work, and Care in Rural America (Better Life Lab, 2022): People in the rural U.S. have a unique need for paid leave — access to paid leave is low, care needs are growing, and distances to hospital-based care are high.


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