opportunities
Care-related needs such as paid leave and child care are gaining recognition and bipartisan support, notably at the state level.
Care has captured our attention
Policymakers and communities across the political spectrum are engaging with caregiving as a central issue in the national dialogue like never before. Media outlets are highlighting care challenges as a pressing concern, with CBS News, for example, running a series on the financial and logistical burdens of supporting the nation’s aging population. In politics, the rising costs of child care became a recurring topic during the 2024 presidential campaign. On the policy front, nearly all 350 federal actions outlined in the 2022 National Strategy to Support Family Caregivers had been completed or were underway by 2024, with federal agencies introducing 40 additional commitments.
States are leading the way
The momentum of this conversation drove meaningful action at the state level. Take Texas, Washington, and New Mexico in the last few years. Texas’ late 2023 state proposition decreased property taxes on child care providers. New Mexico’s 2022 constitutional amendment created, among other things, a sustained source of funding for a range of key supports for young children. Washington’s voters defeated a 2024 initiative that would have effectively undermined the State’s novel public long-term care insurance program.
Care has bi-partisan support
This is smart policy, too. A 2024 poll by BPC Action and Pivotal Ventures found that 92% of Democrats and 82% of Republicans believe that federal caregiving policies would help create a stronger economy. And, from an assessment by the Center of American Progress to a study by the Conference Board, we know that public and private investments in childcare could drive everything from reductions in rates of child poverty and strains on the safety net to robust economic value and job creation.
Who is talking about this

Amanta Mazumdar hilton

Anna Steffeney famtech

Chris Waugh Sutter Health

Elana Berkowitz Springbank

Erica Phillips NAFCC

Jennifer Stybel Pivotal Ventures

Julie Wroblewski Magnify VENTURES

Lindsay Jurist-Rosner Wellthy

Louise Langheier Luminary Impact Fund

Louise Stoney Opportunities Exchange

Lynn Perkins UrbanSitter

Susan Golden Stanford
Washington State protected the capital gains tax that funds child care, and Travis County [Texas] passed Proposition A, which will establish grants for child care providers, including family child care. These are models, and we hope more will follow.

Erica Phillips
Executive Director
NAFCC
Care has emerged as a priority issue among leaders in business, investment, government, and philanthropy. [In 2024], care was raised for the first time as a topic in every Presidential and Vice Presidential debate; care is a truly bi-partisan issue, with 82% of voters saying investments in care should be a priority, and there is growing recognition that it is an economic issue.

Jennifer Stybel
Director, Program Strategy, Caregiving
PIVOTAL VENTURES
While I see federal support as a headwind, I think state programs have a tailwind. Even in this most recent election, we saw more states approving policies which help families and protect health rights.

Lynn Perkins
Co-Founder and CEO
urbansitter
challenges
Political shifts at the federal level introduce uncertainty around care funding.
TBD on federal policy
All political transitions bring change and uncertainty, and that is particularly pronounced under the Trump administration. Themes that undergird the Republican platform–like the role of the private sector, the role of tax policy in enacting reform, and specific campaign concepts like Medicaid reform–may provide some cues to federal policy change to come. However, if the first few weeks of this administration are any indication, it’s hard to bank on a clear care economy agenda for the next four years.
The federal government is the biggest payer in care
This ambiguity is frustrating to many because the Federal Government is the biggest payer of care, from the Child Care Development Fund that provides child-care assistance to the Older Americans Act that supports programs for older adults to maintain independence and well-being. Take Medicaid as an example: every year, Medicaid finances around 45% of births and 50% of long-term care services in the country. The new administration has signaled support for possible work requirements or changes to Medicaid Federal Medical Assistance Percentage, which could have dramatic consequences on funding care. We’ll all be watching with appropriate sensitivity to the implications of federal change to the care economy and for caregivers while the dust settles.
Who is talking about this

Andrey Ostrovsky Formerly CMS

Elana Berkowitz Springbank

Erica Phillips NAFCC

Jake Rothstein Upside

Jennifer Stybel Pivotal Ventures

Julie Wroblewski Magnify Ventures

Laura Kohn Mission Driven Finance

Lynn Perkins UrbanSitter

Melissa Danielsen Joshin

Michael Skaff Sequoia Senior Living

Tolu Lawrence JUST Capital
While there will likely not be any long-tail events in Medicaid funding, there will likely be efforts by conservative states to reduce access to services.

Andrey Ostrovsky
Former Chief Medical Officer
CMS
There’s a degree of uncertainty surrounding the incoming administration and the potential pace of change in the healthcare landscape. While the direction seems to favor increased focus on holistic health and health-related social needs, the lack of a clear picture complicates long-term planning, particularly within the Medicare Advantage space. The ambiguity around regulatory priorities and the timeline for implementation is a challenge for strategic decision-making.

Jake Rothstein
Founder and CEO
UPSIDE
Reductions in the Child Care Development Fund and/or in Head Start would damage the fragile child care sector, with considerable impact on lower-income families, child care businesses, nonprofit organizations, and teachers. Given the preference for child care vouchers from the incoming administration, the advocacy community is hoping child care might be spared even in the midst of an overall federal budget bloodbath. Still, the uncertainty is itself a headwind, and the apparent unlikelihood of a broad federal investment in the sector to fix its broken economics means sector fragility is likely to continue through 2025.

Laura Kohn
VP, Care and Education
Mission Driven Finance
I can imagine a world in which there are cuts to federal support programs, such that companies will feel even more pressure to support employees and fill the gap left by lack of federal-sponsored care programs.

Lynn Perkins
Co-Founder and CEO
URBANSITTER
Potential administration changes to Medicaid and lack of job support would have a significant impact on neurodiversity and disability supports.

Melissa Danielsen
Co-Founder and CEO
Joshin