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This playbook is the result of reporting, research, and over 40 forty interviews with funders, nonprofit leaders, politicians, care workers, lawyers, investors, and policy experts. It explores why creating unity in addressing care issues is so urgent. It highlights what is working across sectors by elevating some of the success stories at the federal, state, and local levels that could be models for future campaign strategies or tactics. This report takes as a starting point the care policy agenda and vision so many organizations have spent years researching, articulating, and fighting for, and offers a practical tacticians’ playbook for how policymakers, activists, business leaders, care workers, philanthropists, media, cultural influencers, and care consumers can be a powerful part of a burgeoning “care movement.” This playbook includes some definitions and context for where we sit in 2023 and is organized into eight tactics combined with case studies. The goal of this work is to help people working on different care issues and in different contexts across the country chart a collaborative and effective path forward with the goals of supporting and elevating care.

This report focuses exclusively on the United States and our unique political, economic, and cultural contexts. While decades of scholarship and activism have contributed to where we stand in 2023, this report largely focuses on the impact and opportunities that arose since the start of the COVID-19 pandemic in 2020. A once-in-a-century crisis that took a sledgehammer to an already weak status quo of care has been a generational turning point. We don’t yet know what historians will say about this moment, but it’s left an unprecedented footprint on how America cares. How our society responds is the future that has yet to be written, which makes understanding this moment all the more urgent and abundantly full of opportunities.

“We don’t yet know what historians will say about this moment, but it’s left an unprecedented footprint on how America cares.”

The Better Life Lab views this playbook as only the beginning. There are so many more wins and instructive lessons to learn from and share. We hope this initial compilation of pandemic-era tactics, strategies, and case studies helps spark more ideas, conversations, and actions. We hope to deepen our in-depth reporting, compelling storytelling, convenings, and collaboration and use our narrative change skills to continue strengthening the connective tissue within the care movement and grow its reach, urgency, and power.

This playbook is the result of reporting, research, and over 40 interviews with some of the key leaders in the care movement, and offers a practical playbook for how policymakers, activists, business leaders, care workers, philanthropists, media, cultural influencers, and care consumers can be a powerful part of a burgeoning care movement. The report identifies eight tactics paired with case studies that are crucial for large-scale social change:

• Power Building
• Union Organizing
• Ballot Initiatives
• Political Money
• Narrative Change
• Building a Bigger Tent
• Fighting the Opposition
• Effective Messaging

While the outcome of the Biden administration’s Build Back Better (BBB) social agenda is widely known, much of the progress care advocates made given their minuscule financial resources is a big success story that deserves more attention.

“What’s the difference between the climate change movement and the care movement?” Kristin Rowe-Finkbeiner, CEO of MomsRising asked, referring to the climate package that was able to pass separately after BBB’s social agenda failed. “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.”

• According to Open Secrets data, during 2021 and 2022, the top three environmental lobbying groups . The top three care groups had 1.4 percent of the lobbying spend compared to .

Based on lessons learned, care movement leaders are refusing to be politically sidelined again.

• Care Can’t Wait Action is a new coalition of care groups aiming to raise $50 million for the 2024 election to make care a central voting issue.
• Campaign for a Family Friendly Economy has a $40 million goal for the 2024 election, running programs across seven swing states.

Care policies about child care, pre-K, and paid leave are popular across the political spectrum in red and blue states when put directly to voters. This report found that bold, meaningful, and even more costly proposals can often do as well or better at the ballot box than smaller, incremental ones.

The report also highlights that voters from across the country have demonstrated that they are willing to raise their own taxes for meaningful policies backed by a well-run campaign.

• In 2020, Multnomah, a county in Oregon that includes the city of Portland, passed a that funds universal pre-K for all three and four-year-olds. It is funded by an anticipated $202 million a year in additional revenue, raised from a .
• Through a new property tax, the city of New Orleans passed a ballot initiative in 2022 that will access over $40 million annually for early childhood seats for up to 2,000 low-income children. Read the full case study here.
• Escambia County in the Florida panhandle passed a ballot initiative with 61 percent of the vote that is for children’s services funded through a property tax. This passed in 2020 at the same time that Donald Trump won the area with 57 percent of the vote.

There are over 50 local funds across the country that . In the face of federal inaction and state house stalemates, it may be one of the most effective levers out there for more taxpayer funding for care.

For those who work in industries such as child care, long-term care, or in-home health and as personal care aides, unions are stepping up to provide helpful organizational structures and political muscle for power building. Political and philanthropic investments in care workers can also produce what President of the National Domestic Workers Alliance Ai-jen Poo terms “triple dignity investments,” where the care workers and their families benefit from high-quality jobs, those receiving care benefit from high-quality care, and the parents and/or unpaid family caregivers can more fully participate in the labor market. “Transforming care jobs will have a ripple effect throughout the economy and culture that’s mindblowing,” said Poo.

Care workers are using state and local governments as the “employer of record” to take their demands to, rather than small employers or individuals who need paid care.

• In Washington State, the to successfully advocate for over $1 billion to be included in the state’s 2023–2025 budget for long-term care. This will result in funding to give homecare workers a starting wage of $21 per hour with benefits.
• In California, organized center owners and workers. In 2021 they won their first contract with the state. The agreement raised the subsidy rate that the government pays to family child care providers who care for low-income children for the first time since 2016.In 2023, unions representing over 560,000 In-Home Supportive Services (IHHS) workers, who are often also the family members of elderly and disabled people who need their care, the California legislature to pass AB 1672 to begin fleshing out details for statewide collective bargaining.

When movement leaders find themselves facing active campaigns from better-funded corporations, business groups, and social conservatives, identifying and defining the narrative around who’s fighting against care policies and why might help coalesce strength.

“You need to make clear what the impediments are,” said progressive messaging strategist Anat Shenker-Osorio. “There has to be a contrast, and there has to be a villain. Otherwise, why is it that we don't have these things? What's going to animate people to get into and sustain the fight?” Clearly that fosters inequality needs to be a part of the playbook, as a counterbalance to corporations who fight against tax increases.

“Historically, pandemics have forced humans to break with the past and imagine their world anew. This one is no different. It is a portal, a gateway between one world and the next. We can choose to walk through it, dragging the carcasses of our prejudice and hatred, our avarice, our data banks, and dead ideas, our dead rivers and smoky skies behind us. Or we can walk through lightly, with little luggage, ready to imagine another world. And ready to fight for it.” —Arundathi Roy¹

Of the many things the COVID-19 pandemic revealed about our society, it showed us clearly how we care for people and who we care about. It also showed us how urgently and how much needs to change about how we care for everyone—especially the most vulnerable.

Over one million Americans died in the worst public health crisis we’ve seen in more than a century—a tragedy that disproportionately fell upon older people, people from marginalized communities, and disabled people. COVID-19 highlighted the horrific conditions in long-term care facilities, whereas of 2022, resident and staff losses made up around 23 percent of all of the deaths in the United States.²

“The pandemic really put into a much sharper perspective—for the broader public—the life and death consequences of being able to live and age in your own home and community,” said Jaimie Worker, Director of Public Policy at Caring Across Generations. “For most people, having that option to choose care at home rather than being forced into an institutional care setting is critical for maintaining dignity and independence.”

“The pandemic really put into a much sharper perspective—for the broader public—the life and death consequences of being able to live and age in your own home and community.”

Beyond the death toll, millions—especially women and people in hard-hit industries—lost jobs or were forced out of the workforce due to caregiving responsibilities. Schools went virtual in some areas for over a year. As child care facilities shut down or went out of business, parents were left to figure out on their own how to teach and supervise children, often while trying to maintain employment themselves.³ The result was learning losses that will likely take years to overcome.

Even though the worst of the global health emergency had passed by the fall of 2023, and prime-age women’s labor force participation rate was at record high levels, the United States is still struggling with the direct fallout of the pandemic and a deeply battered care infrastructure, in addition to political and social unrest, inflation, labor shortages, and mental health crises.⁴

At the beginning of the pandemic, there was some hopeful public policy progress around care issues. In an emergency where quarantining was the central mitigation strategy, a spotlight was quickly shone on America’s patchwork of paid family and medical leave and paid sick time policies. The U.S. is the only high-wealth country that offers no guaranteed paid leave at the national level. But in the early days of lockdown, quickly overcoming long-standing political resistance, the federal government sprung into action on a bi-partisan, emergency basis, instituting a wave of safety net measures that many Americans never had access to before, like paid sick leave and family leave.⁵

In March 2021, President Joe Biden (D) allocated over $152 billion in the American Rescue Plan Act (ARPA) for child care relief funding, child tax credits, Medicaid home- and community-based services, and Medicaid funding, creating tangible examples of what a more robustly funded care infrastructure could look like.⁶ ARPA expanded the Child Tax Credit and changed its structure to allow for direct monthly payments to go to families at a much higher rate. It was a far-reaching, nearly universal payment program for families with young children, which proved to be the most effective program in U.S. history at reducing child poverty.⁷ It cut the poverty rate for 2021 to 5.2 percent, a nearly 50 percent decrease and the biggest single-year drop on record. Parents Together Action, an advocacy organization, found that 90 percent of parents surveyed said the payments were “helpful” or made a “huge difference” for their family.⁸ Advocates of family-supportive policies had high hopes that decades of advocacy were paying off, and once these measures were put into place, they’d eventually become long term or permanent.

But policies that held broad political support during the tumultuous early stages of the pandemic were allowed to expire without more permanent measures being put in place. President Joe Biden’s signature social legislation, (BBB), which would have devoted $750 billion to funding universal child care and pre-K, child tax and earned income tax credits, and home and community-based care, failed to pass. This means that from the perspective of our care infrastructure, we aren’t just back where we were in 2019: We’re much worse off. Despite federal efforts to support the child care industry during the pandemic, 16,000 child care centers closed nationwide, and 100,000 workers left the industry, often in favor of higher paying jobs in other fields, like retail.⁹ As the original ARPA money for child care stabilization has already begun running out without reinvestment, states are facing a $48 billion cliff in federal dollars.¹⁰ The Century Foundation estimates that the loss of these funds could result in 70,000 child care centers closing and over three million children losing their spots.¹¹ Child care policy experts predict that steep fee increases will occur to make up for the shortfalls at centers that remain open, making child care even more unaffordable for families.¹² We’re also sitting on a demographic time bomb; our current weakened elder care infrastructure is egregiously underprepared for the approximately 73 million aging baby boomers, all of whom will be over 65 by 2030.¹³ But before this wave fully arrives, there are already national shortages of home health and personal care aides, which is no surprise given that their median hourly wage in 2020 was $12.98.¹⁴

The disappointment that Build Back Better didn’t pass is warranted, and the care challenges this country faces are daunting. Dawn Huckelbridge, the Director of Paid Leave for All, said: “There were some people who thought, ‘You had this chance with Build Back Better and that's it, and it's over.’ But that's not how policies get passed or how movements get built.” Many activists and funders believe the window is still very much open in the short, medium, and longer term to create transformational social change in how we care for people in America. Policy and practice advances in states and cities across the country show that the groundwork to build that change is already well underway. There’s also a time-sensitive opportunity to get extensions in federal pandemic-related care funding through a program called State and Local Fiscal Recovery Funds (SLFRF). The has identified over 500 programs using $2.8 billion in SLFRF funds for care infrastructure. If advocates are well organized, they may have an opportunity to influence how uncommitted funds are spent before the end of 2024, which could be a meaningful stopgap measure for care programs in some communities.¹⁵ The next few years will be crucial for organizing broad and diverse coalitions and building even more meaningful political power around care issues.

Some past legislative failures, like when former President Richard Nixon (R) vetoed a universal child care bill in 1971, took the wind out of the sails of future efforts for decades.¹⁶ This isn’t what’s happening right now to the care movement. In fact, there are hundreds, if not thousands, of new and reinvigorated voices and efforts that are now plotting a path toward better care infrastructure that will benefit everyone. “The pandemic did a lot of work for us in terms of realizing the breadth of who could be organized in this movement,” said Ai-jen Poo, President of the National Domestic Workers Alliance. Part of the work of advocates in keeping people inspired means tuning to personal or collective ideas of a “north star,” a big, inspiring goal to work toward. Reaching this vision often takes incremental steps over an extended period, but articulating what the movement is actually fighting for can be meaningful in keeping people committed.

“The pandemic did a lot of work for us in terms of realizing the breadth of who could be organized in this movement.”

A few highlights of promising advances in the last three and half years include Biden’s 2023 Executive Order on care, which included more than 50 directives to Cabinet agencies to support care workers and make child care and long-term care more affordable.¹⁷ The U.S. Department of Commerce now requires computer chip manufacturers who apply for more than $150 million in federal funding to submit plans to make child care available to their workers.¹⁸ We saw rare bi-partisan federal victories with the passage of the Pregnant Worker’s Fairness Act (PWFA) and Providing Urgent Maternal Protections for Nursing Mothers Act (PUMP) in 2022.¹⁹ Congressional dads with young children formed the Dad’s Caucus in 2021, and Congress created a new bi-partisan working group on child care. The last three years have marked a wave of successes at the local ballot box for child care funding in Portland, Oregon; New Mexico; and the Florida panhandle.²⁰ We’ve seen increases in pay for unionized care workers through collective bargaining, and the first public long-term care state insurance program take effect.²¹ By fall 2023, new paid family and medical leave laws had passed in five new states since 2020,²² bringing the total number of states with their own paid leave programs to 14, including the District of Columbia. New groups and gatherings are organizing energized activists around care issues like the , the , and . The ., a lab created to redesign care in the twenty-first century, has created the , a wide-ranging list of people reimagining care systems to highlight creative thinkers and their great work to a larger audience. The hosts the CareForce, a multidisciplinary network of professionals interested in care issues. There are newer campaigns and coalitions like , , and the uniting organizations that have been working on care issues, sometimes for decades, to collaborate in new ways. And finally, the ambitious political goals have money to match: A new group, Care Can’t Wait Action, has announced their goal to raise $50 million to make care a central issue during the 2024 election cycle.²³ This is a big, ambitious play for the care movement’s political influence. This amount of money far exceeds previous election spending from separate care groups.

Anna Wadia, Executive Director of , a donor collaborative, describes both culture shifts and the collaboration she’s seeing as, “a sea change in the alignment among groups working across the different pillars of the care agenda….I've been in this field for decades now and never seen this before.”

Care advocates’ hopes were very high when Joe Biden introduced his signature piece of social legislation in 2021 after Democrats won both chambers of Congress and the presidency in 2020. The American Jobs Plan and the American Families Plan, from which Congress pulled to craft The Build Back Better Act (BBB, contained a long wish list of programs to robustly build America’s care infrastructure.²⁴ Paid family and medical leave; universal pre-K; federally funded and subsidized child care programs; funds for long-term, home, and community-based care with living wages; and better benefits for care workers were all included in the original framework. BBB would have springboarded off of the short-term funding infusions of emergency ARPA funds and gotten a long-term, New Deal-level expansion of the social safety net. A Democratic legislative branch trifecta during a once-in-a-century crisis seemed like the perfect condition to get this major legislation through Congress.

The House passed BBB in November 2021, but it never made it to the Senate floor. Two Democrats—one opposed to new taxes and the other concerned about the creation of new safety net programs—complicated negotiations. The objections of Sen. Joe Manchin, (D-WV), one of these lawmakers, ultimately tanked the bill, which Democrats were attempting to move through the legislative process via budget reconciliation. This way, BBB would have required fewer votes than other types of legislation—a necessary political maneuver considering united Republican opposition to the bill.

Still, coming so close to historic, once-in-a-generation care and family sustaining policy change was a crushing blow for both the advocates who worked hard for it and the millions of Americans who would have directly benefited from the policies. It was also a missed opportunity for policymakers looking for levers for long-term economic growth and competitiveness. The data is clear on what not having a robust system of care costs us: The Blue Cross Blue Shield Association has found that unpaid caregiving has a $264 billion per year cost through decreased productivity, absenteeism, and poorer health outcomes for caregivers themselves.²⁵ And there’s plenty of data on what we’d gain. For example, James Heckman, Ph.D., a University of Chicago professor and a Nobel prize winner in economics, has found that investing in high-quality birth-to-five education has a 13 percent per year return on investment in social, health, and professional metrics for the child and improved economic outcomes for their mothers.²⁶

While the outcome of BBB is widely known, how hard care advocates fought for the bill, how well they worked together, and how much progress they made given their minuscule financial resources is a big success story that deserves more attention. In 2020, groups like Caring Across Generations, Paid Leave for All, National Women’s Law Center, MomsRising, and many others came together to form , a coalition “committed to building a comprehensive, 21st-century care infrastructure.”²⁷ The groups worked together throughout the BBB fight and have continued to work closely together to win new care policies as a result of building that movement’s connective tissue. This energized collaboration is exciting because it suggests the movement can be much larger than the sum of its parts. “In the past, groups focused on aging, disability, labor, child care, or paid leave were often pitted against each other for very small pots of [funding],” both philanthropic and government money for programs, explained Nicole Jorwic, Chief of Advocacy and Campaigns at Caring Across Generations. “We are now getting outside of the scarcity mentality and seeing that when we break down silos, we could actually fight for a bigger pie. That's obviously a really good thing. We are all continuing to work together to elevate each other’s issues leading to more power.”

“We are all continuing to work together to elevate each other’s issues leading to more power.”

The difference in capital and political infrastructure between care advocates and other causes within the progressive movement is stark, to say nothing of the well-connected and lavishly funded business opposition that opposed the tax increases on corporations that would have paid for BBB. “What is the difference between the climate change movement and the care movement?” Kristin Rowe-Finkbeiner, CEO of MomsRising asked, rhetorically, referring to the climate package that was able to pass separately as the Inflation Reduction Act after BBB’s social agenda failed.²⁸ “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.”

Ai-jen Poo believes how far BBB got is a testament to the power and popularity of care infrastructure ideas. “A group of determined, mostly women, all running underfunded organizations with very little real political capacity, has seriously punched above our weight and is making generational historic progress on an issue that no one saw was even an issue five years ago,” she said.

Based on lessons learned, these care movement leaders are refusing to be politically sidelined again. Many are using and investing in the tactics outlined in this playbook for different outcomes in the future.

The following portion of the report highlights eight concrete tactics, some of which are already being effectively used in parts of the movement but will benefit from synthesis and more exposure. Each tactic is followed by a case study to give real-world, on-the-ground details of care movement ideas and victories that could be replicated elsewhere. Sharing these tactics and stories will help foster a growing coordination within the movement that can help chart a path winning forward.

Power building is the natural first tactic for any movement to achieve large-scale social and policy change—and it’s foundational to many of the subsequent tactics examined in this report.

Andrea Paluso, the Co-Director of Child Care for Every Family Network, described power building as, “when the people most impacted by the system we're trying to build, actually have decision-making power over that system. We are trying to go beyond coalitions and coordinated work, and driving toward a very particular vision and change.” In other words—it’s people and their lived experience setting the agenda.

Power building can take a lot of forms. It can leverage existing organizations like civic, nonprofit, and religious groups, or involve creating new ones. It can include voter outreach and coordination around candidates, bonds, or ballot initiatives. It can take the form of organizing workers within and outside of unions; participating in town halls, school board, or city council meetings; or lobbying elected officials. It can involve training advocates and spokespeople to share their lived experiences and connect them clearly to larger policies, systems, and other community members or the media. One creative example Paluso shared from her years as the former Executive Director of Family Forward Oregon advocating for pay raises and child care stipends for legislators to encourage people with recent child care system experience to run for office.¹ Child care activists in particular see local and state power building as part of a long-game strategy. “If at any point we have a child care system that would have [more] federal funds coming to states,” said Paluso, “it's going to be really important to ensure that there are impacted parents and providers in decision-making roles around how that system gets implemented.”

While power building is a tactic that has been used by labor unions for decades, the tactic is gaining more traction across the care movement in child care and family advocacy. (A prominent power-building success story is the National Domestic Workers Alliance, an organization that used such tactics to reach domestic workers, cultivate leaders, and organize around initiatives like the adoption of the Domestic Worker Bill of Rights.) Philanthropic funders are taking more notice of power building as an effective tool in promoting social change as well.

Shannon Rudisill, Executive Director of the Early Childhood Funders Collaborative (ECFC), said she’s also come to see how crucial power building is in the early childhood space. In 2014, as the Associate Deputy Assistant Secretary for Early Childhood Development in the Obama administration, she was thrilled when the Child Care Development Block Grant Act got reauthorized, which included many much-needed program improvements. But then Congress didn’t appropriate the funding increases needed to implement the goals. After she left the administration and went to work at the ECFC, she and others in the space started analyzing what it was about movement dynamics that allowed for political, but not monetary, wins. “We identified that what was missing was community organizing that could lift the voices of parents and early educators so that people directly affected by the child care crisis were actually setting the policy agenda,” said Rudisill. Power building is now a central tenet and focus of ECFC’s funder education.

The outcomes when a movement power builds are very different from a top-down policy approach. Rachel Schumacher, Director of the Raising Child Care Fund describes the process as working with people who are the “closest to the pain of [an] �������ܱ�.” This is a real-world example of activists finding and working towards their “north star.”

“We’re now working with people who are asking for millions and billions of dollars [in government funding]. They’re not working on the margins.”

“People are asking for a whole transformation of the child care system and equity-focused public financing,” said Schumacher. “People are going for the blue sky, even if they know they won’t necessarily get it that year. We’re now working with people who are asking for millions and billions of dollars [in government funding]. They’re not working on the margins. And I think for a very long time we were thinking about ‘What can we get?’ Not, ‘What do we deserve? What does this field really need to survive?’ And there’s nothing like looking at the demise of a sector to make you realize [things have to change].”

Takeaway

If you want people committed to organizing, let them set the agenda. It’s important for those who want to be leaders in the care space locally and nationally to not take a position and act as if they already know what’s best for a community. If you want a committed group of on-the-ground organizers, create space to ask people what they are most passionate about fighting for. Listen. Set the agenda from there. Building relationships takes time, and reaching a “north star” of meaningful change is a long game. Hearing real stories from people in their community can stick with voters, make challenges relatable and understandable, and make talking points or mailers much more effective.

Despite the reality, as Ai-jen Poo notes, “care is the work that makes all other work possible.” Yet care workers are some of the lowest-paid and most marginalized in our economy. Early child care workers are who we entrust with the safety, social, emotional, and brain development of our future are making a median salary of $28,520 per year based on data from 2022.² That’s $13.71 per hour, with more than half of child care workers being enrolled in at least one public assistance program due to their low income.³ It’s no surprise that in 2022 there were 100,000 fewer child care workers than there were in 2019, with workers sometimes choosing higher-paid retail and service jobs from large companies who could afford to raise their wages.⁴

Our child care system is caught in a classic market failure.⁵ The Better Life Lab’s Care Report found that parents shoulder 60 percent of the overall child care costs of the system, while federal, state, and local governments pay 39 percent to subsidize tuition for those on very low incomes. Philanthropy contributes 1 percent.⁶ Without robust subsidies, workers are not paid enough to have a living wage while parents are maxed out on what they can afford. Even if you can afford child care costs that often exceed mortgage or rent payments, availability is hard to find. Since even before the pandemic, 51 percent of Americans lived in “child care deserts,” where there were either no options at all or more than three kids for every licensed spot.⁷ This has resulted in an “every family for themselves” system to find care for children zero to five, and a dearth of options for kids five and older for “out-of-school-time.” (This includes summers and all of the time outside of the six and a half hours a day when school is in session, which is far less than a typical full-time work schedule.)⁸ Mothers disproportionately experience career disruptions to support their family’s needs, and clock more child care hours than fathers to compensate for these systemic shortfalls.⁹ These inequities were only made worse during the pandemic.¹⁰ Despite the fact that over 70 percent of mothers with young children are now participating in the labor force, our policy and public opinion are still conflicted about the idea of mothers working for pay.¹¹ As recently as 2013, a Pew Research study found that 51 percent of respondents said they thought children were better off if their mother was at home and not working for pay. Only 16 percent said that young children who had a mother who worked full time were ideal.¹² Even though two-family earners are more common than ever, these attachments to an archaic vision of gender roles and motherhood—that aren’t tethered to the reality of our daily lives or economy—persist and may negatively impact forward progress in investment in the child care system.

Those who work in elder care and disability care, and preserve the dignity and quality of life of some of the most vulnerable in our society, face similar economic hardship and marginalization. The median salary for direct care workers in 2022 was $30,180 per year or $14.51 per hour.¹³ Just over 40 percent of direct care workers use public assistance programs.¹⁴ Many don’t have access to health insurance for their own care.

The way our system of care treats workers in America isn’t an accident. Throughout U.S. history, domestic workers and those in care professions have been overrepresented by immigrants and women of color. The roots of undervaluing their work trace back to the days of American enslavement when enslaved Black women were expected to do domestic work and caregiving for free under brutal conditions. The U.S. also has a long history of waves of female immigrants, who arrived from Europe seeking jobs as maids, or who arrived as indentured servants, working as domestics for a set number of years to pay for their passage to the new world. During New Deal safety net expansion negotiations in the 1930s, for racist reasons, domestic workers were systemically excluded from gains in worker protections, like minimum wage, overtime laws, and the 1935 Social Security Act.¹⁵ Cleaners, laundresses, nannies, and cooks also faced resistance from organized labor itself; early-mid twentieth-century unions were often racially segregated and had sexist views about what was considered “real work.” In Kim Kelly’s book, Fight Like Hell, she writes, “In an ugly preface to the modern debate around valuing ‘hidden labor’ of managing a household, the AFL [American Federation of Labor] and CIO’s [Congress of Industrial Organizations] member unions were in many ways impediments to establishing the legitimacy of domestic workers, the AFL deeming theirs to be “unskilled work” and the CIO declaring the home to not be a workplace.”¹⁶ Because domestic worker pay was so low, they also faced additional obstacles to their unionizing efforts because they couldn’t be funded through the typical system of union dues, and, if they worked in individual homes, had no way to connect with each other or have an “employer of record” to collectively bargain with.

The bonds of love and intimacy created through care work, especially when caring for children and the elderly, have often been weaponized against domestic workers seeking better pay and conditions. In Sarah Jaffe’s book, Work Won’t Love You Back, she shares the story of a worker named Elvira who was told by her employer, “‘You’re just like one of the family….’ When Elvira responded that she had her own family—and that family did not treat her badly—the employer snapped, ‘Remember, you’re just a maid.’”¹⁷

New Synergy between Care Workers and Unions

While unions’ relationship with care workers has been rocky and exclusionary at times, unions are generally responsible for tremendous worker gains in many other sectors during the first half of the twentieth century. However, organized labor has been locked in an existential fight with the deck increasingly stacked against them for more than 50 years. In 1953, 35.7 percent of all private sector workers were unionized.¹⁸ By 2019, it was down to 6.2 percent. In the 1970s, aggressive management practices to fend off unionization and collective bargaining really took hold, and many subsequent efforts to strengthen labor laws under Democratic presidents failed, largely due to organized resistance from corporations. Employers have long fought efforts to increase penalties and close loopholes on National Labor Relations Board rules already on the books.

However, despite decades-long trends in union membership decline, the pandemic fueled new interest in union organizing, inspired by difficult COVID-related work conditions and low pay for most “essential workers.” These conditions contributed to 200,000 more union members joining in 2022 in the United States. Public approval for unions soared to a 50-year high of 71 percent.¹⁹ For those who work in care industries such as child care, long-term care, or in-home health and personal care aides, unions are stepping into the twenty-first century to provide helpful organizational structures and political muscle for power building.

While decades ago the AFL and the CIO actively worked to exclude care workers, today they are all in on the importance of the sector in growing union power. Liz Shuler, President of the AFL-CIO, gave a rousing speech of support at the Care Workers Can’t Wait Summit in April 2023, the first major national care worker conference hosted by the National Domestic Workers Alliance. Schuler explained in a subsequent interview that care worker unionization today looks different than the typical worker versus employer sitting across from each other at the bargaining table, and called care worker bargaining “the ultimate example of creativity and innovation.”

Commonly, the goal of care workers isn’t to negotiate with an individual employer. Care workers at one facility, for instance, typically wouldn’t get far trying to bargain with their individual employers. Unless that facility is part of a larger chain with deeper pockets, like Bright Horizons or KinderCare, most child care facilities are run by single operators or as small businesses operating on razor-thin margins. So child care workers, long-term care workers, direct care workers, and even child care center owners have learned to instead come together to bargain collectively with state or local governments as their “employer of record.” This is possible because state or local government agencies set rules and rates around Medicaid reimbursements or child care and Pre-K subsidies. This has a direct impact on care workers’ pay and benefits. This approach, called sectoral bargaining, has the power to make sweeping changes for large numbers of care workers and providers, rather than, as is standard practice in the labor movement, being forced to make incremental changes employer by employer or worksite by worksite.

Ai-jen Poo explained in her remarks at the Care Workers Can’t Wait Summit in April 2023 that efforts to organize care workers today are similar to organizing manufacturing workers in the first part of the twentieth century—people who were often immigrants working for poverty wages in dangerous conditions. “Through a rising labor movement and changing legal frameworks and our social contract, we were able [in the twentieth century] to create the biggest on-ramp into the middle class in the history of the world,” said Poo. “[Now] we want to make care jobs this generation's version of that on-ramp.” It’s a compelling and logical vision, especially given that the demand for care workers will continue to increase since baby boomers are aging and care workers’ core skills and services simply ������’t be replaced by automation. Employment rates for home health and personal care aides, for instance, are expected to increase by 22 percent between 2022 and 2032, which is anticipated to translate to 684,600 job opportunities, according to projections from the Bureau of Labor Statistics—a leap forward in demand that transcends the average for all other occupations.²⁰ Improving wages, benefits, and conditions will be crucial to getting people into the sector to fill the huge growth.

So what role will care workers themselves play in the movement to change the care economy? In fact, a pivotal one. The Care Workers Can’t Wait Summit was an energetic event—most of the attendees were women of color, and plenty of them were decked out in their union colors and coordinated outfits. Some of the personal stories care workers shared and the rabble-rousing speeches from union leaders were met with revival tent-style calls and responses from the audience. The workers themselves were so passionate about their work; “I change lives,” Sandra Dill, a family child care provider from New Haven, Connecticut, said proudly on the summit stage. “We’re here to build a movement that builds a care system that cares the way we do.”

Even if the general public may still associate union members with the midwestern manufacturer and the burly longshoremen of yesteryear, it’s clear that organized labor sees the women of color, immigrant, multilingual care worker movement as intrinsic to the future of unions. In addition to a town hall with Senators Bernie Sanders (D-VT) and Bob Casey (D-PA), the summit also hosted 15 Democratic members of Congress who came to talk about the importance of this constituency and pay their respects to it. Many, including Senator Tammy Duckworth (D-IL), shared personal stories about how influential care workers had been in their lives. The summit also coincided with President Biden’s announcement of an Executive Order on Care that included more than 50 directives to Cabinet agencies to support care workers. Many participants went on to travel to the White House to attend President Biden’s signing, which was a prominent signal of the rising political power of this group. “The acknowledgment that care work now has a lobby that Democrats cannot ignore is super important,” said Joan C. Williams, a professor at the University of California College of the Law, San Francisco. “[The Democrats] felt this was a politically untenable situation to not have delivered on care policies [with Build Back Better], and so they gave them this.”

Care workers themselves take pride in being fierce advocates for those they care for. “We want caregivers to be valued not only because we are caregivers,” Blanca Carias, a home care provider from Los Angeles said in a statement. “But because the people we care for matter. Without our care, people will suffer and even die.” Speaking about the home care worker shortage in California, she said, “Millions of hours of care are being unfilled every year. That translates into untold human suffering, and we will not stand for that, because we care.”

Other Examples of Care Worker Unionizing

Part of this rising political power comes from what unions have helped deliver to care workers since the start of the pandemic. These examples are all built upon previous, pre-pandemic efforts but are signs of recent forward progress.

Building off robust funding wins in Washington State, the Service Employees International Union (SEIU) 775 and others organized its care workers to successfully advocate for over $1 billion to be included in the state’s 2023–2025 budget for long-term care.²¹ This will result in funding to give homecare workers a starting wage of $21 per hour with benefits and a 15 percent increase in Medicaid payments for nursing homes, which will fund better care for patients and worker raises.

In California, Child Care Providers United, a joint project between United Domestic Workers and SEIU, organized center owners and workers. And in 2021, at the height of the pandemic, they won their first contract with the state.²² The agreement raised the subsidy rate that the government pays to family child care providers who care for low-income children for the first time since 2016.

In 2023, unions representing over 560,000 In-Home Supportive Services (IHHS) workers, who are often also the family members of elderly and disabled people who need their care, successfully lobbied the California legislature to pass AB 1672.²³ In the fall of 2023, Gov. Gavin Newsom’s administration was fleshing out details for statewide collective bargaining. Unions argued that increasing wages for IHHS workers was crucial to keep up with the coming demand. California’s Master Plan for Aging states that the “over 60 population is projected to diversify and grow faster than any other age group.²⁴ By 2030, 10.8 million Californians will be an older adult, making up one-quarter of the state’s population.”

Takeaway

Organizing care workers and improving pay and working conditions is the foundation on which all other care movement goals are built on. Care worker unionization is already a tangibly successful tactic. But because organized labor’s influence is geographically dispersed, advocates in many parts of the country may not be attuned to how transformational care worker organizing can be. (In 2022, 30 percent of all union members lived in New York and California.)²⁸ Those who are committed to the care movement but are not involved directly in worker rights should consider learning more about these efforts, shout them from the rooftops, and support them however possible. This can look like supporting worker negotiations, protests, and strikes if you live in an area that’s organizing in this way. Those based in areas with hostile conditions for formal organizing—like in the South and other states that are “right to work”—should learn about other worker alliances and community efforts to improve pay and benefits as part of state and local budgets.²⁹

Many care movement leaders and activists interviewed for this report agreed that ballot initiatives at the state and local levels are among the most effective tactics for creating meaningful progress in building care infrastructure. Putting care policies and funding directly in front of voters showcases their widespread public appeal beyond any political party affiliation, as they have succeeded in red states as well as blue states. Ballot initiatives are also a way to bypass statehouse partisan stalemates or dysfunctional local governments.

Ballot initiatives have also succeeded in nudging politicians to act; in July 2023, Maine became one of the handful of states to adopt a paid family and medical leave program via legislative action. Governor Janet Mills (D) stated explicitly in an op-ed explaining her support for the legislative proposal that she agreed to this negotiated measure to avoid the question being put to voters.³⁰

One reality of ballot initiatives, however, is that every state has different rules around them, and some states don’t allow them at all or are facing efforts by Republican lawmakers to limit them.³¹ But for the states, cities, and counties that do allow ballot initiatives, a successful one is not as simple as standing on a street corner gathering signatures and coasting through an election. According to Ballotpedia, in 2022, the average cost of signature gathering for getting an initiative or veto referendum on the ballot was $4.08 million.³² Ballot initiative contributions around some statewide hot-button issues have reached hundreds of millions of dollars per campaign as interest groups seek to influence the outcome.³³

It can take years of power building to get a meaningful policy on the ballot. In New Mexico, a constitutional amendment guaranteeing a right to early childhood education passed with 70 percent of the vote via ballot initiative 2022.³⁴ It was heralded at the time as one of the most exciting early education initiatives in the nation. Yet it was far from an overnight victory: it took around 12 years of relationship and power building. While working as an organizer, years before a constitutional amendment was even a tangible possibility, Erica Gallegos, who is now the Co-Director of the Child Care for Every Family Network but worked for years as a labor and community organizer, at one point had “stepped foot in every single child care center in the state of New Mexico.” It took voter education to explain New Mexico’s unique Land Grant Permanent Fund—the source of funding advocates sought to pay for the measure—and why voters should feel entitled to use this money for education. It also took patience to follow through on needed steps to reach their goal, which included successfully backing four candidates in 2020 who supported the amendment to run in the Democratic primaries against incumbent Democrats who were blocking progress on it. This tactic is called "primarying." With the support of allies like New Mexico Governor Michelle Lujan Grisham (D), activists got the proposal on the ballot. Even with no funded opposition, supporters of the amendment spent $5.6 million on education and get-out-the-vote efforts to secure their victory.³⁵

A Powerful Under-the-Radar Ballot Initiative Tool: Voter-Approved Children’s Funds

Another effective strategy for going straight to voters to get funding for early childhood initiatives is through voter-approved children’s funds. This is a little different from other types of ballot initiatives that create policies or constitutional amendments. This tactic instead creates, in an election by voters, pools of money for a range of children’s services outside of the K–12 school day. There are over 50 local funds across the country that raise $1.5 billion annually for children’s well-being.³⁶ Voter-approved children’s funds sometimes fund existing programs and nonprofits already doing work in the community, and in other instances help develop new local infrastructure and programs.

The success of voter-approved children’s funds proves an effective counter-narrative to several tropes about why care initiatives aren’t well funded, including that there isn’t much political will for these programs and that most voters never want their taxes raised. Children’s Funding Project, a nonprofit that helps communities expand strategic public financing for children, has found that people across the political divide are willing to vote to raise their own taxes to pass voter-approved children’s funds, and once implemented, they grow in popularity. “Sometimes these initiatives initially win with like 51 or 54 percent of the vote,” explained Elizabeth Gaines, CEO of Children’s Funding Project. “And we’ve found of all the ones we’ve supported, if they have to go for reauthorization, they tend to win over 70 percent, winning up to 20 additional points of voters.” She sees this as a sign of the funds’ popularity, especially when voters see the impact of more funding for children.

Voter-approved children’s funds 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.³⁷ 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.³⁸ The success of that initiative was also bolstered by business leaders who felt that kids’ services needed a stable source of funding for the whole community to thrive. This felt especially urgent in the wake of Hurricane Sally in September 2020, which caused $300 million in damages. A local business and hotel owner offered $55,000 to incentivize other businesses to donate to the campaign. The initiative is now raising $10 million per year for 10 years funded through a property tax increase.

Another benefit of the voter-approved children’s fund tactic is that they are contagious. When one passes in one area, it’s common that neighboring municipalities and counties get interested in bringing a fund to theirs. This allows for great collaboration and tactic sharing for activists at the state level.

Winning voter-approved children’s funds through ballot initiatives not only shows politicians the popularity of care policies but also the political might of the people organizing around them. This helps groups build momentum for whatever their next priority is and also pressures legislators to be sure proper funding is attached to current and future care initiatives when needed. Politicians also certainly take notice when voters choose to raise their own taxes in support of care initiatives.

Gaines also thinks voter-approved children’s funds are an important part of unlocking other forms of government funding. “We have to be incentivizing each other all over the place,” she explained. “The feds need to be incentivizing the states, the states need to be incentivizing the locals. Locals need to be pushing up and saying, ‘Hey, we’re doing it. Why aren’t you doing it?’”

It is worth noting that while pre-K, children’s program funding, and paid leave have had success via ballot initiatives, not all care policies have made progress with this route. There are not any prominent examples of successful elder care or disability care ballot initiatives. Washington State has actually passed, via the legislature, the country’s first state-sponsored long-term care plan, which went into effect in the summer of 2023.³⁹ However, it faced delays and backlash over its requirements and implementation details.⁴⁰ It even faced a ballot initiative to repeal it. But, as a testament to the power of the issue, the petitions to repeal the initiative failed to get enough signatures.⁴¹ The lesson is that conditions for each policy and state are unique and require lots of momentum to make care policies successful, and ballot initiatives are not one size fits all.

Other Examples of Change at the Ballot Ballot Box since 2020

In 2020, Multnomah, a county in Oregon that includes the city of Portland, passed a Preschool for All initiative that funds universal pre-K for all three and four-year-olds. It includes significant salary increases for early educators, raising the pay for teachers from $31,000 a year to $74,000 a year—in line with the county’s public kindergarten teachers.⁴² It will be funded by the anticipated $202 million a year in additional revenue raised from a new income tax on wealthy individuals, 1.5 percent for single filers with taxable income over $125,000 and $200,000 for joint filers over $200,000.⁴³ Based on income thresholds, 90 percent of residents pay nothing.⁴⁴

In 2020, Colorado passed FAMLI, a paid family and medical leave program, by ballot initiative with 57 percent of the vote.⁴⁵ It will provide paid leave to eligible workers with a qualifying need to care for a child, a loved one, or their own health issue for up to 12 weeks per year, with an additional four weeks available for pregnancy or childbirth complications. Virtually all workers in the state are eligible for the program, which is funded through payroll deductions that split less than 1 percent of workers’ wages between employees and employers, or just the worker portion for self-employed workers who choose to participate in the program.⁴⁶

Takeaway

Voters want to go big on care. Care policies pertaining to child care, pre-K, and paid leave are popular across the political spectrum in red and blue states when put directly to voters. Bold, meaningful, and more costly proposals can often do as well or better at the ballot box than smaller, incremental ones. Voters have also repeatedly demonstrated that they are willing to raise their own taxes for meaningful policies backed by a well-run campaign. It’s important to highlight that groundwork for ballot initiatives can sometimes take years—New Mexico took over a decade—and campaigns at the state level can be expensive to pull off, with the average cost for signature gathering being just over $4 million. And while there isn’t a one-size-fits-all solution, since rules vary widely by state, advocates spreading the word about and supporting ballot initiatives and voter-approved children’s funds are a crucial tool for the care movement. In the face of federal inaction and state house stalemates, it may be one of the most effective levers out there for more taxpayer funding for care.

Many leaders believe that in order to create systemic change, the care movement must use all the tools of political influence available. While many organizations advocating for care issues started as tax-deductible 501(c)(3) charitable nonprofits, numerous prominent groups such as Paid Leave for All, National Domestic Workers Alliance, and MomsRising, along with funding groups like Early Childhood Funders Collaborative and Children’s Funding Project, have started separate organizations, which allows them to lobby for bills, endorse candidates, and campaign for ballot initiatives. Additionally, some groups like the Campaign for a Family Friendly Economy also have (PACs) that allow them to do independent expenditures, meaning they can spend money independently of a candidate’s campaign to support them getting elected. There is a growing understanding that if the care movement wants to have the big successes that other social causes have enjoyed, this coalition needs to also be a big money player in politics and do the kind of trusted long-term voter engagement that other organizations, like the over 50-year-old League of Conservation Voters, have done effectively.

“Donors in the care, women’s, and mom movements [historically] have wanted to resource direct services over direct change,” said Kristin Rowe-Finkbeiner, CEO of MomsRising, when describing the shift in mentality. “They’ve wanted to resource ‘the sandwich,’ instead of [resourcing] the movement to try to change the policies so that we don't have to do sandwich handouts.”

501(c)(4)s are proving effective across the care movement landscape. The Children’s Funding Accelerator, a sister (c)(4) organization of the Children’s Funding Project, supported Ready Kids New Orleans by donating $115,000 to the campaign. While they weren’t the only donor, their support helped cover campaign costs like paying for polling, communications, and stipends to organizers, which succeeded in unlocking $40 million a year in funding. Their theory of change is that funding one or two organizers—or paying a team of part-time advocates to do canvassing to fuel a ballot initiative that will unlock long-term government funding for child and youth priorities—is an excellent way to get more bang for your buck in social change.

“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 the X, Y, Z campaign, and that then generates $30 million a year in perpetuity for kids, it’s a pretty good return on investment.”

Care in Action, which is an allied (c)(4) organization with the National Domestic Workers Alliance, is teaming up with numerous other aligned groups to launch Care Can’t Wait Action with the goal of raising $50 million for the 2024 election to make care a central voting issue.

MomsRising and the Campaign for a Family Friendly Economy are two of the organizations that have done the most ongoing electoral work in care. Rowe-Finkbeiner shares that MomsRising estimates there are 76 million mom voters in the United States, and since 2006, they’ve focused on multilayered direct engagement of these voters. “One of our funders found [through a third-party analysis] that we were more than two times more effective at getting out voters in 2020 [than] the average efficacy of the other dozens of organizations that they funded and three to four times as effective in selected states,” she said. But this, of course, takes money. “It costs about $2 per voter contact. We’re not going to get anywhere without being able to connect with real voters.” She’s also concerned about the amount of right-wing disinformation that they are seeing low-frequency mother voters get. “As a movement, we must wake up and realize that we have to resource constant communication.”

In the 2022 election cycle, MomsRising had over 64,000 volunteers texting voters, running events, and writing nearly a million “mom-to-mom,” handwritten get-out-the-vote postcards. “We could have done millions more if we’d had the funding,” Rowe-Finkbeiner added.

The Campaign for a Family Friendly Economy (CFFE) started running voter contact programs in 2015 to support policies at both the state and federal level. For the 2020 and 2022 elections, they focused on the angle that supporting care policies lowers costs for families, along with showcasing to candidates that care is a needle-moving issue. “Unlike some of the issues I’ve worked on in my career, care issues are really top of mind for voters,” said Sondra Goldschein, Executive Director of CFFE. She explains that voters are thinking about their own experiences of navigating “high costs for families, making ends meet, and avoiding impossible choices between earning a paycheck and caring for yourself or a loved one. So we’ve got this tailor-made moment to be driving that message with voters in the states that everyone is paying attention to in terms of who controls the Senate, House, [and] governorships, and who wins the presidency.”

With a $30 million budget split across their (c)(4) and their PAC, in 2020, CFFE knocked on 2.2 million doors across 10 battleground states. Their goal for 2024 is $40 million and to focus their programs across seven battleground states. One specific win Goldschein is proud of is the work they did targeting voters in Cobb County, a suburb of Atlanta, in support of Senator Raphael Warnock’s (D-GA) 2022 re-election. Warnock supported Build Back Better’s care agenda and could likely be a crucial vote during his six-year term for future federal care policies, depending on the Senate makeup following the 2024 election. His opponent broadly criticized federal spending.⁴⁹ Over the course of the general and run-off elections, CFFE knocked on over 550,000 doors and sent over 580,000 pieces of mail, focusing on how Warnock supported policies that lowered costs for working families.

Political spending on care issues is really only getting started, and while some of the most resourced groups mentioned here are hoping to make eight-figure investments in the 2024 election cycle, this will be a tiny fraction of all the political spending made by PACs and Super PACs on all issues over the next year. The 2020 election was the most expensive on record, with $14.4 billion spent, and there are no signs of spending slowing down in 2024.⁵⁰

Many care leaders pointed to the climate movement as having a strong history of political organizing and voter engagement that they hope the care movement can learn from and emulate. But environmental groups also had more capital to spend on lobbying during the intense debates in 2021 and 2022 around social and climate legislation. While there are countless factors that impact what legislation gets passed, the reality is that the care movement was not able to get $750 billion in spending for care infrastructure in the Build Back Better Act through the Senate in 2021, but the climate movement was able to get the $300 billion Inflation Reduction Act—perhaps the most consequential piece of climate legislation to date—passed in 2022. While some may argue that the climate and care movements have nuances that make the comparison difficult, many care leaders specifically brought it up because of the vastly different legislative outcomes during the same period.

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.

The social component from Build Back Better faced fierce resistance from business groups, which is discussed in detail later in this report. While these business groups lobbied on a range of issues in 2021 and 2022, not just Build Back Better and the Inflation Reduction Act, the differences in spending between these influential business groups with decades of lobbying connections compared to some newly lobbying care groups is stark.

Open Secrets data reveals the difference in spending of the top three care-oriented groups’ lobbying efforts compared to the top three major business groups who opposed the social policy legislation in Build Back Better. The top three care groups had 1.4 percent of the lobbying spend compared to top business groups who opposed BBB.

Takeaway

Building political power with money to back it is necessary to win the next federal opportunity for a care agenda. Therefore the care movement will have to continue to make the case now, and in future election cycles, to progressive political donors about the value of supporting the care movement’s specific political infrastructure. By building influence through PACs, (c)(4)s, and lobbying, the care coalitions can mimic the playbook from other successful progressive efforts, like the climate movement. Wielding political money—alongside donating and volunteering for individual candidates—builds relationships, allows care groups to demand accountability from the people they are helping elect, and lets politicians know there will be a political price for those who oppose or impede care policy progress. The care movement is already racking up meaningful wins and implementing effective political strategies like the work completed for Sen. Warnock’s re-election by Care in Action (over 3 million total direct voter attempts) and the Campaign for a Family Friendly Economy (over 550,000 door knocks in one county).⁵¹ MomsRising mobilized 64,000 get-out-the-vote volunteers nationwide in the 2022 election. Financial resources are the only constraint in greatly expanding these efforts.

At the virtual Democratic National Convention in 2020, millions of viewers were taken to an early education classroom in Springfield, Massachusetts, to hear a message from the former presidential candidate, Senator Elizabeth Warren (D-MA) During her speech, Warren shared some of her own stories about how the child care help from her Aunt Bea had been vital to her life and career.⁵² Warren explained the idea that just like we invest in roads, bridges, and utilities so people can work, “child care is infrastructure for families.” The slogan, “Childcare is infrastructure,” became an immediate catchphrase, amplifying the framing first coined by Ai-jen Poo in her 2015 book, The Age of Dignity.⁵³ Against the 2020 backdrop of a raging pandemic—when many schools and child care centers were closed and parents were desperate for support while trying to maintain employment—this phrase made the personal struggles so many faced during the pandemic crystal clear as a systemic issue, countering the long-standing narrative that care is an individual responsibility that families must face on their own.

While culture change happens over many small moments over many years, this section will look at a few examples of changing narratives about who is responsible for care and who does caregiving in America since the start of the pandemic. Our public policy choices for decades have reinforced the idea that care decisions are private choices for individual families rather than critical social problems that should be addressed as a public good through public policy. While women and mothers disproportionately do more parenting and caregiving than other groups, focusing on our care crisis as “a women’s problem” is a wildly incomplete portrait of caregivers.⁵⁴ Reinforcing stereotypes can perpetuate the status quo of society expecting women to absorb the failure of our care systems, and it can close off building a broader coalition for policy change around care.

Challenging the Status Quo about Who’s Responsible for Care

While high-profile media moments like Warren’s may have a lasting impact, empirical research and a steady stream of high-quality storytelling over time can also counter harmful narratives, raise awareness, and create a drumbeat of urgency for change. Movement organizations play a role in this by generating impactful content and research as well as influencing how media covers caregiving and gender roles. The Better Life Lab (BLL) deploys a variety of strategies as part of its narrative change mission to impact diverse audiences and elevate the value of care. The Lab does this by producing character-driven narratives in print, podcasts, and graphic and video stories, backed by rigorous data and policy analysis while focusing on solutions. Showing bright spots of hope and change, research on ‘solutions journalism’ has shown it can help people “see” a different future is possible and give them the energy to fight for it.⁵⁵ To expand the chorus of writers and content producers and the energizing bright spot solutions they can share, the Lab offers journalism reporting grants, reporter convenings, op-ed workshop training, and editing for academics who research care and work-family justice.

Examples of research that expands our understanding of gender and caregiving include BLL’s 2020 report, Engaged Dads and the Opportunities for and Barriers to Equal Parenting. This report found that dads today are happy that their role has expanded beyond fathers of previous generations and that over 90 percent “view love, affection, and the teaching of children about life to be ‘very important.’”⁵⁶ The study concluded that “the next steps for achieving equal parenting should focus less on changing the hearts and minds of individual men…and should focus instead on policy and workplace change.” The 2021 report, A Portrait of Caring Black Men, found minimal differences between how white and Black men fulfill their caregiving responsibilities, and that Black male high-intensity caregivers were more likely to have performed hands-on medical or nursing tasks than their white counterparts.⁵⁷ This challenges the harmful racist trope of the “absent Black father,” which throughout history has been used to incorrectly attribute socioeconomic inequities to the supposed moral failings of Black men rather than entrenched systemic forces.

Other influential BLL reports, Lifting the Barriers to Paid Family and Medical Leave for Men in the United States and Providing Care Changes Men, combined data, journalism, and storytelling to discover that an overwhelming majority of men valued caregiving as much as breadwinning and wanted to share it equally with their partners.⁵⁸ We need policy and culture change to support these realities. “Contrary to some prevailing narratives, our research found that men needed paid time off work to give care in the same ratio as women and that men with intensive caregiving responsibilities have had to reduce work hours or leave the workforce entirely at rates similar to women,” explained Brigid Schulte, the Director of BLL. “We found that it was the experience of giving care that transformed men’s attitudes and behaviors—and yet workplace practices, cultural expectations, and the lack of policy prevent many of them from having that experience. Some of our qualitative research showed that men in paid caregiving roles, contrary to the stereotype that care is low-skill or ‘women’s work,’ reported feeling challenged by and proud of their work.”⁵⁹ Creating this research and promoting it widely creates empirical counternarratives and tangible ways to challenge sexist assumptions.

In addition to research, organizations like Equimundo have global programming to “achieve gender equality and social justice by transforming intergenerational patterns of harm and promoting patterns of care, empathy, and accountability among boys and men throughout their lives.”⁶⁰ They do this through research and programs around care equity, gender socialization, and violence prevention. In addition to direct work with men and boys, they have invested in media campaigns that highlight different versions of masculinity. Caring Across Generations is also specifically targeting culture change around millennial men and caregiving more broadly, with Man Enough to Care, a five-part mini-series featuring a number of successful men sharing their personal journeys with care.⁶¹ “Traditionally care responsibilities have fallen on women,” said Nicole Jorwic, Chief of Advocacy and Campaigns at Caring Across Generations, on why she thinks men speaking up about care has an outsize impact. “I do think it hits differently when men are talking about these issues and the need for those collective solutions because it’s not an expected voice.” In 2023, Caring Across Generations also launched the Creative Care Council, with celebrities like Seth Rogen and Megan Thee Stallion, to highlight themselves as family caregivers to parents and siblings.⁶²

Changing Minds through Storylines

While research, education, and real people’s stories can be part of moving the needle, thinking about how gender, care, and family policies are portrayed in TV and film is another frontier for culture change. Caring Across Generations, Equimundo, and BLL have all been collaborating on guides and workshops with Hollywood writers to get more accurate, nuanced portrayals of caregiving and care issues on TV and in movies.⁶³ The Geena Davis Institute on Gender in Media, along with Equimundo, analyzed 225 popular scripted TV shows that aired between 2013 to 2020.⁶⁴ They found that “while men are depicted doing hands-on caregiving at higher rates than in the past, they are too often shown as abusive, incompetent, and/or emotionally distant. These persistent tropes point to the need for more stories that show men as imperfect but connected, emotionally responsive, invested, and equitable caregivers.” Given studies citing that Americans watch more than two and a half hours of TV per day on average, this is a ripe area to tackle in hopes of influencing attitudes.⁶⁵

BLL’s Senior Fellow Vicki Shabo describes why she got interested in influencing fictional stories after 10 years of working with national and state-level advocates on paid leave issues. After paid leave was made vulnerable during Build Back Better negotiations, “I just started to think about what else was needed to catalyze more urgency and understanding about the need for paid leave specifically, but really all of these [care] policies,” she said. “I started to think about making the challenges that people feel as individuals visible in a different way and…helping to shift narratives about individual responsibility and individual blame to understanding that these are systemic failings for which systemic solutions exist.”

One goal of working with Hollywood is to make writers aware of harmful tropes they could be perpetuating like “the apprentice dad” who ������’t manage basic child care or the “guilty worker” who’s constantly apologizing and hiding their caregiving. Another is creating more nuanced, true-to-life depictions that make care visible and disrupt gender stereotypes. Shabo would like to see more stories reflect current political realities, which is why she created a Hollywood tip sheet for Re-Scripting Gender, Work, Family, and Care.⁶⁶ An example of creating these positive storylines would be a TV show accurately discussing a state’s paid family leave program in the context of telling a boss about a pregnancy. Showcasing working parents dropping their kids off at a child care center or having a plot point about how central and valued a nanny is to a family with young children are all potential ways to make visible and elevate care to millions of viewers.

In addition to continuing a steady stream of high-quality journalism to challenge status quo narratives and point to real-world solutions, this entertainment-focused work is an exciting lever for culture change used by other social movements and issues—and, like some of the generational shifts that are underway—can speed along positive narratives for the care movement.

Takeaway

Significant generational change is underway in attitudes about gender and caregiving roles, and many forms of narrative change can support this progress. Quantitative research, like BLL’s Engaged Dads and the Opportunities for and Barriers to Equal Parenting, found that over 90 percent of dads “view love, affection, and the teaching of children about life to be ‘very important,”’ but they need more structural and social supports to be the kind of fathers they aspire to be.⁷⁷ News coverage and fictional depictions have often lagged behind the “hearts and minds” change that is already happening. Sharing stories and advocating for change by high-profile millennial dads, celebrities, and “unexpected voices” like caregivers that defy stereotypes, can have an outsize impact on shifting conversations. Additionally, creating guides and workshops to support more nuanced, true-to-life depictions that make care visible and disrupt gender stereotypes in TV and film can help the larger public imagine a better world and connect the dots between individual struggles, systemic barriers, and solutions.

The pandemic has undoubtedly brought like-minded care groups together in new ways. But to advance progress, the movement must bring in allies whom activists may not agree with 100 percent of the time. You ������’t build coalitions with strangers, and two groups ripe for targeting future issue-based collaboration in the care movement are business groups and faith organizations.

Loretta Ross, a pioneering Black feminist activist and one of the co-creators of the theory of Reproductive Justice, has created a framework around “circles of influence” as a way to think about effective alliances and coalitions.⁷⁸ The idea is that there are people who agree with you 90 percent of the time, 75 percent of the time, 50 percent of the time, 25 percent of the time, and 0 percent of the time. She critiques the left for spending any energy trying to convert 90 percenters to 100 percenters as a waste of energy. Instead, she urges widening the circle to bring others into your cause. The care movement could continue to strengthen internal connective tissue while at the same time working to build a larger tent with the 75 and 50 percenters where it’s possible, to work together on a specific set of issues. To do this requires accepting rather than obsessing over areas of disagreement and not “calling out” other activists for working with people who don’t pass all progressive ideological litmus tests. “I’m an organizer,” said Ai-jen Poo about her big-tent ambitions. “Everything is persuasion to me. It’s exciting to have people who don’t agree with you on everything in your tent because then you’re actually doing your job.”

Vania Leveille, Senior Legislative Counsel at the ACLU, has worked on tactics and strategies—including coalition building—that strengthened the bi-partisan support needed to pass the federal Pregnant Worker Fairness Act (PWFA) and Providing Urgent Maternal Protections For Nursing Mothers (PUMP) Act in December 2022 and agreed with the sentiment. “We have to remember why we’re here, and it’s to help the folk who need us. They don’t care about, ‘Oh, this coalition partner has done this, or these groups have done that.’ What matters are the workers, the women, the families, and the kids that we want to help,” she explained. “We need to do everything we can. And that means sometimes you look past some differences within the coalition.”

Bringing Businesses into the Care Movement

There are important 75 and 50 percenters within the business community that the care movement must continue to actively court and engage. “Most businesses, especially post-pandemic, really understand care as a workforce issue,” said Poo. “When they think about the supply side of things, they understand why child care matters and why supporting your caregiver employees really does matter. I want anyone and everyone in the tent. That is how we get to the kind of generational solutions that we need.”

Dawn Huckelbridge, Executive Director of Paid Leave for All, said: “We have heard more from the private sector [in the first few months of 2023] than we have in my entire career. I think this said something profound about not just the narrative change, but the market and political calculations that are happening. I think they see [paid leave] as a winning bi-partisan or nonpartisan issue and they want to join.”

Small businesses and corporations operating on the state and local level are a great first group to target more directly because they are often closer to and most impacted by the problems around the care economy. The entire state of North Carolina is considered a child care desert and waitlists for infant child care average one year in some areas. Activists and some lawmakers have effectively engaged business leaders on how child care shortages are tied to worker shortages, and how building up the child care industry is crucial for North Carolina’s economic development. More state support for child care has found unexpected champions, like David Farris, a 70-year-old CEO of the Rocky Mount Chamber of Commerce. (Rocky Mount is a rural area in central North Carolina.) He personally never faced child care struggles with his own children since his spouse stayed home, but as he learned the extent of the problem during the pandemic, he’s come to see increasing the availability of high-quality child care as crucial if local businesses are to land lucrative projects for his area. The vocal advocacy of people like Farris is one of the things that has led to the North Carolina Chamber of Commerce coming out with its strongest support in recent history of a child care bill. In 2023, a bi-partisan group introduced a proposal to add $300 million to the state budget to stabilize the child care industry by extending compensation grants once American Rescue Plan Act (ARPA) money ran out.

Getting business people who are highly influential in North Carolina politics to lobby at a statehouse that’s controlled by a Republican supermajority was a major shift in strategy. Despite new tactics and momentum, lawmakers and advocates weren’t able to get the $300 million in funding included in the state budget. Instead, the legislature is directing an agency to spend any remaining ARPA funds to extend the compensation grants for early educators, which will only delay the state’s funding cliff for about six months. North Carolina State Rep. Ashton Clemmons (D), one of the co-sponsors of the bill, was frustrated by the lack of state investment. “It is devastating to the families and child care providers of North Carolina that there is no additional investment in our child care workforce,” she said. “We already see in other states that reached the cliff in loss of child care stabilization supports, there will be significant decreases in providers and spaces for our children. North Carolina deserves better.” While this is a major short-term setback, Clemmons is committed to continuing to fight for early childhood funding at the state level.

“Giving up is not an option,” she said.

Main Street Alliance (MSA), a national network that represents small business owners, has been partnering with community advocates for years to get paid family and medical leave (PFML) passed in Minnesota and a number of other states. For a long time, MSA members supported Minnesota’s PFML legislation even when it didn’t have a chance of passing, pointed out the organization’s Executive Director Chanda Causer. But in the 2023 legislative session, when political tides turned and the state moved towards passing it, “60 of our small business owners and community supporters rallied at the state capitol in support of paid leave. We had member after member telling their personal stories about why it’s important,” explained Causer. “Small business owners bring a lot of pragmatism and cachet to the space because they’re talking about themselves as individuals, but they also talk about, ‘here’s what I generate for the community that we serve.’”

As Causer pointed out, getting in conversation with future partners and building up trust in those relationships even when there isn’t a looming election, ballot initiative, or legislative item, is an important coalition strategy. That’s why it’s important to have more formal initiatives like the council on the future of the care economy, which is co-chaired by the CEO of Moms First Reshma Saujani and the CEO of Care.com Tim Allen. Moms First and theSkimm launched a campaign in 2023 called #showusyourchildcare, meant to engage businesses on their child care support policies. Both are great examples of expanding the tent that can result in long-term success.

Bringing Faith Groups into the Care Movement

Another constituency ripe with opportunity to grow the tent is faith groups. Progressive religious groups, like the National Council of Jewish Women and the Unitarian Universalists who’ve taken proactive stances in support of abortion rights, can be natural allies to bring more explicitly into care movement work.⁷⁹ But the outreach should not stop with avowedly progressive organizations. There is no way around the fact that growing the tent to include some Christian and more conservative faith organizations that have opposed abortion is a prickly recommendation. Reproductive rights are seen as integral to the values of many care movement leaders. In 2022, the Supreme Court’s decision in Dobbs vs. Jack Women’s Health Organization abandoned nearly five decades of legal precedent when it overturned Roe v. Wade, eliminating the constitutional right to abortion and allowing states to greatly restrict and in some cases outlaw the procedure.

As a result, care movement activists noted there is a lot of anger towards people who are only becoming more interested in care policies now that abortions are much harder to get. “I understand the concern or the lack of wanting to make strange bedfellows with people who have put bed bugs into your bed,” said Anat Shenker-Osorio, Principal and Founder at ASO Communications. This anger is valid, and there are opportunities for this outrage to be shared and used to build a multifaceted coalition.

Christians, and even Evangelicals as a subset, are not a monolith, and beginning to engage Christian leaders who could be 75 percenters could be an important in-road. The nonpartisan Center for Public Justice (CPJ) is a nearly 50-year-old Christian think tank and civic education society that promotes pluralism in public life. Their ‘Families Valued’ portfolio of issues includes promoting paid family leave and pregnancy accommodations, maternal health access and family-oriented benefits, and a child care ecosystem that serves America’s diverse families well. Non-religiously affiliated care activists could find broad alignment with CPJ, even if some of their positions in other parts of their portfolio related to religious hiring and institutional religious exemptions might be areas of disagreement. Rachel Anderson, a fellow at CPJ, said she is happy that CPJ supported and allied with other Christian organizations to support the 2022 passage of PWFA. But she is clear she doesn’t view her organization as part of a big happy tent yet. “I wouldn’t yet use the word ‘coalition,’” she explained. Collaborating with people like Anderson could also be a potential bridge to 50 percenters who could be issue-specific allies like the National Association of Evangelicals, the Conference of Catholic Bishops, and the National Latino Evangelical Coalition, who have recently come out with or publicly reiterated their support for paid leave.

Christian groups supporting family policies aren’t new: They were part of the coalition that got the 12 weeks of unpaid leave guaranteed to eligible workers in the 1993 Family Medical Leave Act and have also signed on in support of the recent passage of the PUMP Act. Some groups are now coming to newer stances about care based on political realities and their own self-reflection. “Broadly speaking, institutions and groups that are more typically aligned with American Evangelicalism are looking at [care policy] a little bit differently. Some are thinking more, in a post-Dobbs world, about the need for material support for women and children,” said Anderson. “More women are raising their hands and saying, ‘We need to have paid family leave for all moms; we need to support women at work.’”

Anderson has also found that ​​there are opportunities within faith communities to discuss care work from multiple perspectives, including the experiences of women of color and the birth-equity movement. “We recently did an event about Black motherhood, and it's been really well received,” Anderson said. “For people for whom this is a newer topic, there’s an opportunity to connect [the dots] between material support, the history of racism, and the needs of the most vulnerable moms. If we look at those pieces altogether, we can see the value of supporting women in more material ways.”

Another way to start the conversations that lead to big tent coalitions may be to give more platform to the religious beliefs of care workers themselves. There are large numbers of care workers of all backgrounds—white, immigrant, and care workers of color—who are devout Christians. Highlighting more discussion of their faith and how it relates to their job choices and activism around improving care could be a compelling starting point. Poo pointed out that “a lot of care workers do this work because it’s God’s work.”

For instance, at the 2023 North Carolina Child Care Day of Action, state Rep. Jim Bergin (R), an older white man, spoke to a rally of advocates about his support for more child care funding from the state legislature. He warmed up the crowd full of Black women from across North Carolina with a reference to a song he loves, “Jesus Loves the Little Children,” which was met with plenty of “Amens.” While his line “I believe child care begins at conception” was met with a mixed reaction, he got a lot of approving applause for his many Bible references.

Closing Loopholes

The Pregnancy Discrimination Act (PDA) of 1978 was supposed to prevent pregnancy discrimination in hiring, promotion, and access to benefits. After the passage of the Americans with Disabilities Act (ADA) and the Americans with Disabilities Amendments Act (ADAA), some argued that pregnant people should have the same access to workplace accommodations as other workers with similar physical limitations. However, the way the laws were written and interpreted was confusing and often resulted in a frustrating Catch-22. Workers weren’t sure of their rights and often didn’t file complaints. Employers weren’t sure how accommodations for pregnant workers—like water bottles, stools, or temporary light duty—compared to accommodations for on-the-job disabilities. Even legal case rulings created confusion.

For instance, a FedEx employee created a spreadsheet of 261 other employees who’d received temporary work assignments, but she still lost her case because the judge ruled those examples weren’t similar enough to her pregnancy-related request.⁸⁵ PWFA clarified what workers can expect and what employers should provide when it comes to “reasonable accommodations” for pregnant and postpartum workers to help them stay on the job.⁸⁶

One major problem with existing breastfeeding protections under the 2010 Break Time law was not only that nine million workers were excluded, but there was no enforcement mechanism for employers who didn’t follow the law. PUMP largely closes this coverage gap and allows people to file lawsuits immediately, giving the law teeth.⁸⁷

State Momentum, Effective Storytelling, and Outreach

As lobbying continued steadily at a slow burn on the federal level, advocates began organizing for action at the state level. Many red and blue states passed their own versions of PWFA and PUMP, sometimes unanimously and on a bi-partisan basis.⁸⁸ This allowed federal representatives to see that the legislation didn’t result in big rises in litigation for businesses or other unforeseen negatives. It also created excitement among advocates to continue winning more state policies and, ultimately, a national policy.

Advocates for both bills cited finding compelling stories for news articles, congressional hearings, and direct constituent and lawmaker meetings as highly effective in helping elected officials understand the problem and get on board. “We were able to point to real people who wanted to work, who wanted to support their families and couldn't. We also had the right kinds of stories from many parts of the country, including rural America and from red states like Alaska and West Virginia,” said Leveille of the ACLU. “We had stories that could resonate with the Republicans we were trying to reach.”

Rather than pushing these pieces of legislation as solely civil rights or worker rights issues, advocates effectively courted business groups about the benefits of each of the bills and collaborated on language that helped to get them on board. Avoiding litigation is a big priority for the business community, and a 2015 Supreme Court decision, Young vs. UPS, sided with the employee holding that the plaintiff was able to make a claim under the PDA and ADAA. But it seemed to create only more uncertainty about employer obligations. It also didn’t slow down pregnancy discrimination complaints being filed to the Equal Employment Opportunity Commission. Along with the fact that many states had their own versions of these laws, which created complexity for companies operating in different states, advocates were able to bring business leaders in, not to just neutralize opposition but to add them as powerful allies to reach certain members of Congress they had strong relationships with. Both pieces of legislation also provided standards for businesses that were relatively inexpensive to comply with—like a stool to sit on, regular water breaks, or a private empty room for pumping—not new taxes or high structural compliance costs.

Wide Coalitions in Polarized Times

PWFA had over 700 organizations that signed on to the bill. “You don't often see the U.S. Chamber of Commerce, the ACLU, and the Conference of Catholic Bishops on the same side of an issue,” said Leveille. PUMP’s coalition was smaller, but also had breadth, with over 160 organizations signing on, including the ACLU, the Chamber of Commerce, the American Academy of Pediatrics, and the National Retail Association. PUMP passed the House on a bi-partisan vote of 276-149 and 92-5 in the Senate.⁸⁹ And PWFA’s final vote passed the House 315-101 and the Senate 73-24.⁹⁰

Both the difficulties women faced in particular during the pandemic, and bi-partisan interest in getting people back into the workforce to address severe labor shortages as part of the country’s economic recovery may have been powerful factors in finally bringing the bills to a vote in the Senate in 2022. Tactics included traditional meetings, lobbying, polling, rallies, as well as a full-page ad in the New York Times. “Our coalition’s willingness to say [to our allies in the Senate] we’re counting on you to get this done was very important,” said Leveille. “The reality is that very often the obstacles to getting things done is because Republican lawmakers deny us the votes we need to move legislation. At a certain point, that wasn’t the obstacle here, right? Instead, the challenge was making sure the leaders in the majority prioritized the bill and made time to move it forward.”

The premise of both bills elevated concerns from people on all sides of the political spectrum. Those who were concerned about pregnant and new mothers’ workplace rights and maternal health outcomes could find something to be enthusiastic about in these bills, as could people who want to make it easier for those who want to work to support their families, rather than be forced out of work, which could lead to needing to rely on forms of government assistance.

The fact that the PUMP Act extended protections to “essential workers,” who were excluded in the previous law, added political weight “especially after the pandemic when you’re thinking of nurses and teachers,” said Liz Morris, Deputy Director of the Center for WorkLife Law. “They were literally putting their lives on the line, taking care of everyone during the pandemic, and then they ������’t even express breast milk to feed their children.” Many also noted that the formula crisis in 2022, and the weeks of intense media coverage around it, helped elevate the importance of the PUMP Act and gave it a sense of urgency, helping to build on the years of legwork advocates had already put in.

PWFA and PUMP passed on the same day at the end of 2022. Both laws going into effect in 2023 are a meaningful two-pronged victory for workers and provide exciting examples of how the care movement can make meaningful, bi-partisan progress during a hyperpolarized time. While the passage of these bills is an unequivocal victory, it’s important to note that one of the reasons they succeeded with such wide bi-partisan support is that they cost the government and businesses virtually nothing. No real government spending is needed to implement these laws. Providing a chair, bathroom breaks, or an empty office is a very light lift for companies. The clarity these bills provide will likely save employers money, time, administrative burden, and costly litigation. Future federal wins on issues like paid leave and child care that will likely require new sources of public investments are harder fights, but advocates can still learn from these federal wins while charting a path forward.

Takeaway

If the care movement is committed to racking up significant wins, groups must be willing to work with a wide coalition of people. It’s counterproductive to focus on areas of disagreement and create litmus tests for working together. Two groups ripe for targeting are business groups concerned about the economic and workforce impact of our weakened care infrastructure and faith groups. Even though abortion rights are a strong value of many long-standing care activists, there may be opportunities to work with Christian groups on pieces of a larger care agenda in the post-Dobbs world. It’s also important to celebrate that bi-partisan, federal action is possible with coalition members that include business and faith groups, as demonstrated with the passage of PWFA and the PUMP Act in 2022.

After bringing as many people into the tent as possible, it’s also important to recognize who you ������’t get on your side in the short and medium term. The movement should not write people off quickly, but also must be realistic about when it’s facing powerful opposition. While many in the movement know that the benefits of care policies are backed by tons of social and economic data and activists are committed to the moral righteousness of care causes, neither of these things alone will effectively counter prominent and well-funded opposition.

Who Opposes Care Legislation, and Why?

It’s important to understand why opposition exists, and for many opponents, it comes down to taxes. One of the ways Biden’s White House proposed paying for Build Back Better (BBB) was through enforcing and collecting taxes from wealthy individuals and corporations that were already on the books. The White House also pointed out that, in practice, the largest corporations in the United States paid just 8 percent in taxes in 2019. BBB would have imposed a 15 percent minimum tax on large corporations with over $1 billion in profit and a 1 percent surcharge on stock buybacks, which often lavishly benefit corporate executives.⁹¹ The opposition to paying more taxes and checks on how company leaders enrich themselves was fierce.

Opposition to state and local initiatives may have their own nuance, but in general, the specific opposition to BBB is instructive to understanding the landscape of who opposes care policies generally. The groups that have a track record for opposing care agenda policies fall roughly into three categories:

• Large Industry Organizations. Many of these groups have enormous political sway and lobbying power at the federal level. They don’t want corporate taxes raised. Some of these groups include the U.S. Chamber of Commerce, the Business Roundtable, and the National Retail Federation (NRF). The NRF opposed the spending in Build Back Better because it would roll back some of �鶹������ý corporate tax cuts, even though millions of retail workers working hourly jobs would have greatly benefited from the bill’s proposed social programs.⁹² The U.S. Chamber of Commerce, which did support PWFA and PUMP, staunchly opposed the tax hikes on corporations that were proposed to fund the legislation and took a lead role in organizing cross-sector opposition by using fears of inflation and increasing the national deficit as an argument against BBB.⁹³ This was in spite of the fact that their own foundation has released reports like Equity in Child Care is Everyone’s Business.⁹⁴ The Business Roundtable, which represents 200 of America’s most prominent CEOs, has put out position papers on the critical importance of early childhood education for workforce development, along with extensive reports about racial justice and business’ role in closing the racial wealth gap.⁹⁵ Yet they publicly opposed BBB due to corporate tax increases. The Rate Coalition, whose primary mission is to oppose any corporate tax increases and counts companies like Target, CVS, Lowes, CapitalOne, and AT&T as members, ran seven-figure digital advertising campaigns against BBB. Their chief spokesperson is former Sen. Blanche Lincoln (D-AK).⁹⁶
• Individual Large Corporations. Companies like Exxon Mobil, Pfizer, and the Walt Disney Company all conducted their own lobbying blitzes against BBB.⁹⁷
• Staunch Social Conservatives. This group is to the right of Christians who could be recruited under Care’s “Big Tent.” Many in this group don’t believe in policies or government spending that contradict their interpretation of Christianity or traditional family roles. This manifests as opposition to mothers working outside the home. This group is part of the Evangelical Christian political apparatus, which is highly influential for many Republican politicians. Around BBB, they drummed up fear that a non-discrimination provision that’s standard in many federal laws would bar preschools and child care centers with religious curriculums from receiving federal funds.⁹⁸ The administration countered that the proposal would not impact curriculum, but instead would prohibit hiring discrimination and excluding children with disabilities. Still, opposition was fierce and may have had an influence on Sen. Joe Manchin (D-WV), who ultimately didn’t support the reconciliation package.⁹⁹

Takeaway

The care movement has not yet entered the arena of taking on its opposition. Compelling spokespeople, clear messaging about corporate greed and inequality, amassing the power of sheer numbers of care voters and consumers, and pressuring theoretical political allies to stand up to corporations’ pressure to keep taxes low all must be explored. The opposition to care policies won’t magically melt away. The movement needs serious strategy and effort if it wants to go up against the deep-pocketed interests that stand in its way on major federal legislation.

What comes after movement leaders have done the hard work of organizing, listening to people on the ground, and setting an agenda based on their lived experience? Making sure broadly popular care policies are talked about, written about, and messaged in a way that connects with people is an important connective thread with all the tactics discussed so far.

When the Ready Kids New Orleans proposal was on the ballot in 2022, community organizing partners like the Power Coalition for Equity and Justice were able to effectively rally their base of supporters interested in criminal justice reform with the message that the initiative was an economic justice issue for low-income families. Meanwhile, Bill Hammack, a prominent business leader in the New Orleans restaurant world, came out in support of the campaign as crucial to helping the city’s vital hospitality industry—one that will help all of the city’s industries recover and thrive after COVID-related challenges and worker shortages. The same ballot initiative, but very different messages to different groups.

The Chamber of Mothers is a national advocacy group with a mission statement of uniting mothers as advocates to create a better America. They have 15 local chapters across the country and are looking to expand to more communities. Their goal is to bring together moms and mom supporters around what people agree on around a care agenda without entrenching into partisan stances. The need for tailored messaging and bridge-building is especially clear to Executive Director Erin Erenberg, who lives in Hilton Head Island, South Carolina. “There are moms who have a lot to say beforehand, and then they also have a lot to say to just me after, but [at a Chamber of Mothers meeting] they’re reluctant,” said Erenberg of the specific challenges of organizing in her community. “When I press people, I hear, ‘I have a local business, and if people think that I’m this liberal thinker, it might hurt my business,’ or ‘My husband votes Republican, and I wonder how people might feel if I’m supporting some things that don’t feel on-the-nose Republican.’”

Erenberg isn’t discouraged by this; she believes it’s “an opportunity to understand [through relationship-building and conversation] how we can unite around issues that impact all of us.” Part of that is finding common values outside of polarized left-right binaries. While reaching diverse constituencies from different angles is important, having clear and winning messaging for ballot initiatives and other campaigns is an important tactic to make organizing and power building effective.

According to messaging strategist Anat Shenker-Osorio, the care movement and its progressive counterparts have a chronic problem with holding up policies rather than outcomes as its central message. She points out phrases accepted as shorthand in the movement, like “universal pre-K,” don’t necessarily translate into effective winning slogans for coalition building or success at the ballot box or legislatures.

“‘Paid time to care’ was much more animating and convincing to people. They wanted to extend greater time and greater amounts of money for ‘paid time to care’ than they did for ‘paid leave.’”

“‘Universal pre-K’ is a policy. The outcome of your policy is your message,” she said. Of the outcome, she said: “You drop your kid off at school, and she’s loving life while she’s learning, and you don’t have to stress about it.” Her mantra is “sell the brownie, not the recipe.” Her research testing even found that the widely used phrase “paid family leave” isn’t as effective as activists might hope. “We found that ‘paid time to care’ was much more animating and convincing to people. They wanted to extend greater time and greater amounts of money for ‘paid time to care’ than they did for ‘paid leave,’” explained Shenker-Osorio. “It’s because you’re not paid to leave your work. Why would someone pay you to leave your work? You’re paid to care for your family.”

Effective messaging is also a neutralizer against misinformation or disinformation about care policies. Painting a picture of positive outcomes that are not mired in wonky policy details rather than repeating misinformation over and over in the service of “fact-checking” is an often overlooked but key messaging strategy.

There are numerous ways the care movement can take the advice of Anat Shenker-Osorio to better message the “brownies” (wonderful outcomes), and not the “recipes” (the policy details). Luckily, the “brownies” of the care movement are abundant. They are children thriving in pre-K, looking at picture books with a beaming, well-paid, well-trained child care provider by their side. They’re parents with the time to lovingly bond with a precious new baby without worrying about losing jobs or paying bills. They’re a happy family surrounding a beloved elder reaching another birthday while living at home instead of at a facility. They’re a home health aide earning a living wage joyfully hugging their client who’s disabled.

A great example of this type of “brownie messaging” Shenker-Osorio pointed to is an ad from Kaiser Permanente called “.” The video is filled with heartwarming moments set to heartstring-pulling music—including a baby’s first steps, a mom in military fatigues coming home to her daughters, a multigenerational summer party, a grandfather teaching his granddaughter to make flower leis, a gay couple celebrating their marriage, and so on. This ad is for a health maintenance organization (HMO), and yet there are no images of hospitals, doctors, blood draws, chemotherapy treatments, or anything remotely unpleasant you’d associate with medical care. The final tagline is “We want you around for all of it.” This is the “brownie” of great health care: A full, happy, healthy, and long life. Similar messaging is a natural slam dunk for much of the care agenda.

Takeaway

The positive outcomes of great care policies are easy to find and make great stories. Examples include children jumping for joy during a child care play session or pre-K class; parents holding a newborn while on paid leave, free from worry about losing jobs or paying bills; or a beloved elder reaching another birthday while living at home instead of at a facility. The care movement can improve its messaging by focusing on the abundant positive outcomes of robust care infrastructure rather than focusing on policy jargon or wonky details.

Despite the vast wealth individuals have accumulated in the United States, no amount of charity money can “fix” the multifaceted care crisis. Newer strategies in philanthropy and political giving can play a tide-turning role in accelerating progressive social change through the care movement. Most philanthropic giving in the United States goes to colleges, hospitals, and arts institutions. Only 1.6 percent goes to women’s and girls’ causes, of which care-related philanthropy is often a small subset.¹ However, as the largest wealth transfer in the history of the world begins between baby boomers and their mostly millennial children, this is a tremendous opportunity to educate and engage a new and younger group of philanthropists.²

There are a few high-profile philanthropic efforts to address the systemic problems of our care system, such as , which represents a consortium of foundations and donors and aims to raise and give away $50 million in five years, and Pivotal Ventures, which Melinda French Gates has pledged a billion dollars over 10 years via philanthropic grants and company investments that take aim at gender inequality while holding a strong focus on how caregiving specifically impacts women’s equality.³

Care is a gateway to solving many important social challenges. Fixing the care economy is a path to address gender, racial, and economic inequality. Funding care infrastructure will improve educational outcomes, strengthen workers’ rights, and support middle-class families. It also has the cascading effects of helping families escape poverty and supporting women’s workforce participation and leadership capacity. By building care infrastructure, we also change narratives about the value of paid and unpaid care work. Shannon Rudisill, Executive Director of the Early Childhood Funders Collaborative, has noticed how more funders are recognizing these intersections by seeing how early childhood education and access to it is a racial and gender justice issue. “A big turning point, in addition to COVID, for our organization, was the racial reckoning of 2020,” said Rudisill. “Those two really went together in terms of more funders coming to us and saying, ‘Wait, we want to learn more about what you’re doing. It seems like you’re addressing this problem in a different way.’’’

Investing in care is a great ROI. Individuals and the private sector ������’t fix care problems alone. The best answer is recognizing that care and care infrastructure are public goods requiring public investment. Philanthropists and political donors giving to organizers to unlock state and federal investment in care through legislation and ballot initiatives are like a matching fund on steroids. An example: The Early Childhood Funders Collaborative awarded a grant to Parent Voices California to raise their staff capacity and fuel a campaign to permanently waive child care co-payments for low-income families in California, which were temporarily suspended during the pandemic. The result? In 2023, the state legislature passed a budget making permanent the change that has saved families $195 million and will continue to do so. Political and philanthropic investments in care workers can also produce what Ai-jen Poo terms “triple dignity investments,” where the care workers and their families benefit from high-quality jobs, those receiving care benefit from high-quality care, and the parents and/or unpaid family caregivers can more fully participate in the labor market. “Transforming care jobs will have a ripple effect throughout the economy and culture that’s mindblowing,” said Poo.

Old problems deserve new tactics. Those focused on women’s advancement have often focused on the gender wage gap and women’s leadership participation. As of 2019, the U.S. won’t achieve gender equality for 208 years, according to the World Economic Forum—a statistic that Melinda French Gates has cited as influencing her thinking and strategy around Pivotal.⁴ This is why French Gates and other leaders in the space are beginning to focus more on removing systemic barriers women face around caregiving rather than merely supporting individuals navigating broken systems or providing direct services. Focusing on the dollars and cents issues of helping families, kids, and the workforce through building care infrastructure rather than encouraging women to “girl boss” their way out of their challenges may be the fresh approach we need to build a bigger tent of philanthropic interest. Reshma Saujani, the founder of Moms First, puts it more bluntly: “We’ll never get to gender equality if we don’t finish fixing the problem [of care]. This is the thing that’s standing in the way. All that money, all those resources that have been put into women’s leadership training—it’s in vain. This is the �������ܱ�.”

Similarly, one donor’s political giving directly to a candidate is a short-term investment in one election cycle. However, investment in political power building through 501(c)(4)s and PACs can create a longer-term political constituency around a care agenda with the staying power needed for transformational change. In New Mexico, organizers like Erica Gallegos worked for over a decade on power building by visiting every child care center in the state and engaging in public education on New Mexico’s Land Grant fund. Advocates also supported candidates to challenge conservative Democrats who opposed their efforts in primaries, so at the right moment, they had built deep support for a very tangible initiative for New Mexico Governor Lujan Grisham (D) to champion. This targeted and long-term strategy is very different from making an individual donation to a progressive governor who theoretically supports early childhood investment. The new initiatives around the 2024 elections, such as Care Can’t Wait Action’s $50 million campaign, will be a large-scale case study in attempting to make care issues central to a presidential election cycle.

Start supporting federal and state care policy initiatives, including paid family leave and public investment in universal care infrastructure. The long-term health of businesses requires employers to support public investment in universal care policies and programs that increase productivity, expand and stabilize the workforce, and attract the best workers.⁵ Investing in care infrastructure will unlock more workforce talent and .⁶ For business leaders who rely on contract labor or wish to see more start-ups and entrepreneurial efforts, ensuring that workers have access to universal, portable public benefits is key. In addition to individual corporate support, consider starting independent business coalitions that seek to advance employee-based care benefits and larger care agenda initiatives. A great model for this is the Second Chance Business Coalition, which includes over 40 large private sector companies working on reforming policies related to reintegration and hiring those with criminal records.⁷

Carry on your commitment to care. Creating robust benefits around paid family leave and care for your employees is both the right thing to do and good for business, and there are many great resources, like from the Society of Human Resources Management, that can help advise on this.⁸ There is also a burgeoning family technology or “FamTech” sector with startups aiming to support employees with caregiver needs through employee benefit programs. A few examples include , , , , , , and , to name a few. However, make your commitment long-lasting and not subject to the latest market trends. Do not reduce care benefits as part of cost-cutting measures. It can weaken local care economies; frame care as a “nice to have” perk rather than addressing a fundamental need; undermine long-term goals around workplace diversity, loyalty, and retention; and break employee trust.

Extend your diversity, equity, inclusion, and belonging efforts to caregivers. Caregivers are the fastest-growing workplace identity group, with 73 percent of employees identifying as a caregiver.⁹ For companies to better support their needs, good data is a first start and line of defense against workplace discrimination. Start tracking caregiver status and be clear in your policy manual that you will not discriminate or retaliate against caregivers so that they will feel safe disclosing their status. Encourage systemic changes by encouraging the Equal Employment Opportunity Commission (EEOC) to require all companies to do this. It’s important to note that while women make up the majority of those with significant family and elder care responsibilities, a higher share of male caregivers had left a job over their caregiving responsibilities.¹⁰

For those facing immediate care crises like a year-long child care waitlist or losing a string of home care aides because of low pay, know that your personal struggles are not the result of personal failures. Improving our care infrastructure is a long process that won’t likely address immediate needs. This section illustrates how you can support a more robust care economy.

Support worker efforts to unionize, get raises, and improve conditions. Care consumers committed to systemic change will ultimately benefit from staying focused on the big picture: Supporting worker pay is a crucial step towards broad solutions for everyone. If cost increases for families are a downstream effect of improved worker pay, be vocal about it and push for the next step of progress, including major new public investments to help make care affordable for all families while at the same time ensuring all care jobs are good jobs. Staying united with workers will strengthen the overall care movement efforts to get much-needed government funding and subsidies to address the care crisis broadly.

Join local efforts to improve care. Find out what nonprofits and political organizations in your area support care issues, and get involved as a volunteer or member. Some national organizations that you can get involved with from anywhere include , , , and .

Support ballot initiatives and issues-based campaigns. If you have the means to make political donations, let politicians know how important care is to you as a voter by supporting care-oriented PACs and 501(c)(4)s like , , , , and Paid Leave for All Action.

Attend town halls, candidate forums, and elected official meetings; write letters; make noise; and advocate for care. Politicians need to hear your stories and know that paid leave, child care, and care for older and disabled adults are vote-swaying issues for you and that you demand action.

There are many examples of workers being central to legislative and ballot-based care victories in recent years. Examples include New Mexico’s universal child care constitutional amendment, securing $40 million per year for child care for low-income kids in New Orleans, paid leave efforts in Colorado and Minnesota, and securing $1 billion in long-term care funding in Washington State.

Know your rights around caregiving. The , , and the provide legal support on a range of issues, including gender and caregiver discrimination and harassment, as well as advice on rights under the new Pregnant Worker’s Fairness Act (PWFA) and Providing Urgent Maternal Protection for Nursing Mothers Act (PUMP). Although the the ability to leverage meaningful penalties against companies for violations, it is still a very important independent government organization for protecting worker rights. Workers can file charges and petitions with them directly. The EEOC is also a crucial agency for enforcing all federal discrimination laws. They have the power to investigate claims and file lawsuits, so people who think they’ve experienced discrimination as an employee or a job applicant have recourse to file a charge with the commission.¹¹

Join a care union or worker organization. There’s lots of exciting union and worker organization momentum for care workers in different parts of the country. Find out if there is union or worker-organizing activity in your area to join or support. Some of the major organizations that represent care workers include the Service Employees International Union (SEIU), United Domestic Workers (UDW), and the American Federation of State and County & Municipal Employees (AFSCME).

Join other influential organizations. For those who live in “right to work” states with little traditional labor union presence, there are still many other options for building collective power. In the South, there’s a new union called the and sectoral economic justice organizations, like , that can be great places to organize around care worker concerns. Other organizations like the , , , and provide various resources, training, education, and organizing for workers outside of a traditional union structure.

We need a transformational change and investment in our care system. Keep listening to constituents, advocates, and those closest to the problem about their challenges and the lives they want to build with work and care—their “north stars.” Help them work towards this hopeful vision rather than saying the goals are unrealistic. Bold policy ideas for care, even when it involves raising taxes, have a strong track record of voter support and have shown strong and long-lasting benefits. Sell the “brownie” of positive outcomes rather than the “recipe” of policy details. Champion the idea that strong care policies support businesses and the economy, address poverty, and help rebuild and stabilize middle-class families. Tell vivid stories about this. Telling the story of inequality, how corporations have benefitted wildly in profits and tax avoidance at the expense of hard-working families, is a potent message. Showcase the children, families, those with disabilities, and elders harmed by this grotesque inequality and greed, and paint a picture of what a different, happier, and more equitable world is possible with a robustly funded care infrastructure.

Use your platform to tell your own care stories and highlight the full broad and diverse spectrum of people in the care economy as spokespeople for care. Normalize caregiving as a part of life for everyone. Learn about and don’t play into harmful stereotypes like “the apprentice dad” who ������’t manage basic child care, the “guilty worker” who’s constantly apologizing and hiding their caregiving, or the “harried mom” who ������’t handle it all. Commit to creating more nuanced, true-to-life depictions that make care visible and disrupt racial and gender stereotypes, along with reflecting current political realities.