Support for Care Economy Policies by Political Affiliation and Caregiving Responsibilities.

Importance: Identifying effective and financially viable strategies to meet the care needs of perons with impaired function is a policy challenge for high-income countries with aging populations. The 2022 National Strategy to Support Family Caregivers identified a range of actions to support caregivers, while family-oriented policies to promote the affordability of care were promoted by both candidates in the 2024 presidential election.

Objective: To examine public perceptions of federal policies to support older adults, adults living with disabilities, and their family caregivers by political affiliation and caregiving status.

Design, setting, and participants: This cohort study included adults in the CLIMB study, a nationally representative, longitudinal panel. Data were collected in March and April 2024. Data analyses occurred from September 2024 to February 2025.

Exposures: Self-reported political party affiliation and caregiving responsibility.

Main outcomes and measures: Endorsement of 6 policies. Responses based on a 5-point Likert scale were dichotomized to contrast "strongly" or "somewhat support" with "strongly oppose," "somewhat oppose," and "neither support nor oppose." The probability of support and differences across political affiliations was presented.

Results: Of 2059 respondents (1035 female individuals [50.9%]; mean [SD] age, 49.0 [18.2] years), 394 (20%) reported having caregiving responsibilities, with no significant difference across political affiliation. Endorsement was highest for policies to make care in facilities (1657 [79.0%]) and homes (1600 [75.4%]) more affordable, expand eligibility for financial access to care (1618 [77.3%]), and increase the capacity of the paid caregiving workforce (1649 [78.3%]) and was lower for expansion of paid family leave (1342 [65.4%]) and payment of family caregivers (1223 [61.2%]). Endorsement by political affiliation was most similar for policies to make care at home more affordable (13.7-percentage point difference; 95% CI, -20.4 to -7.1) and least similar for paid family leave (33.4-percentage point difference; 95% CI, -39.0 to -27.7). While respondents with caregiving responsibilities were more likely to support paying family caregivers, political affiliation was associated with the endorsement of policies to support the care economy that was stronger in magnitude than sociodemographic characteristics (eg, sex) or caregiving experiences.

Conclusions and relevance: The results of this cohort study suggest that, despite some differences by political affiliation, there is high support of policies to support the adult care economy, suggesting a policy window to advance legislation and executive action to address the care needs of aging populations and populations with disabilities.