Building a Care Society with Angelina Drake

In this moment when healthcare access feels increasingly precarious, Angelina Drake reminds us that care work is political work, and that our voices matter. A former home care worker who spent a decade working on care justice issues through long-term care policy and advocacy for nursing home and home care workers, Angelina now serves as Chief Development Officer at Protect Our Care, a healthcare policy organization working to lower healthcare costs, increase coverage, and improve health equity in the U.S.

We talk about why care work is systematically undervalued, how the current political moment threatens healthcare access for millions, and what it means to build political will in your own community. Angelina shares how becoming a parent radicalized her understanding of care, why talking to each other is our most powerful tool, and how empathy can fuel—not drain—our advocacy work.

Angelina Drake is a former home care worker who spent a decade working on care justice issues through long-term care policy and advocacy for nursing home and home care workers. In recent years, she focused on direct levers of political change supporting voter engagement, campaign, and other civic action research at the Analyst Institute. Angelina now serves as Chief Development Officer at Protect Our Care, a health care policy and narrative change organization that works to lower health care costs, increase health coverage, and improve health equity in the U.S. I spoke with Angelina about building the political will to improve care at a perilous moment for both health care and civic engagement.

Learn more about Angelina’s work at protectourcare.org

Transcript

Lee: 0:04

Welcome back to Empathetic Presence. I'm your host Lee. In this moment, a lot of us are thinking about healthcare, how we care for ourselves and each other. I feel so honored to support so many people working within the healthcare space, people working in public health, and our guest today been working in the care economy for as long as I have known her. Her career has blended care advocacy and political engagement. Angelina Drake. Chief Development Officer at Protect Our Care, an org dedicated to expanding and protecting healthcare access, affordability, and equity in the us. Prior to joining Protect Our Care, she served as managing director of development and strategy at the Analyst Institute, a voter engagement and campaign research firm. Angelina has been a fundraiser and strategist for healthcare and civic engagement causes for more than 15 years. A former home care worker, Angelina spent a decade in nonprofit fundraising and leadership roles in the Care Justice movement. I am so excited to talk to Angelina about building a care society. This topic is deeply personal to all of us and has perhaps never been more relevant than this moment in our society. Angelina is also one of my longest time clients, so I'm really excited to sit down with her and talk about her work, her voice, and how we can move forward in building a Care society. Welcome Angelina Drake.

Angelina Drake: 1:47

Hello, Lee. Thank you so much for having me.

Lee: 1:50

Angelina, it's so nice to see you and and just have this conversation in this moment when so many of us are having our healthcare threatened. so I wanna hear from you a bit about why you have rooted your entire career in this idea of care.

Angelina Drake: 2:10

Some of my earliest jobs were as a home care worker, and later as a nanny. I studied public health in. And after university, I spent over a decade working to create change in what we call the care economy. My focus has been primarily on home care workers and nursing assistants. This is the largest workforce in the country. These are the people who care for older adults and disabled people in every community across the country. And it is some of the most important work that happens in our society, caring for our family members at large, whether it's long-term care, childcare, or making sure that, you know, we as as parents or other family members are healthy ourselves. This is really critical to the fabric of every community across the country, and yet the work of providing care is afforded the least amount of dignity, especially when it comes to childcare and long-term care. And so this is work that's hugely valuable and yet very difficult and poorly compensated, and families struggle to be able to access affordable quality care. So whether we've considered it or not care work is central to every person's story.

Lee: 3:25

Wow. I'm just holding on to what you said about this work is afforded the least amount of dignity thinking about this in an intersectional way. I know you and I, you and I have talked about this so much over the years, how that lack of dignity is then impacting a lot of communities that might have less access to resources can you talk about why providing care has been such a huge challenge in our country.

Angelina Drake: 3:57

This is work that, uh, for a variety of factors has been relegated to the informal space. Often in the home, there's an assumption that there will be one family member. Traditionally this has been women or it's been work that's been done for hire. Um, or, you know, going back even further, this was work that women in slavery were forced to do for other families. And so it is. Assumed to take place in the home. It's seen as outside of the formal economy, and yet if you were to remove family care from our society, the formal economy would not function. Right? And so because this work has been traditionally tied to women's roles in society, first and foremost, it's been undervalued. And it's work that I think, especially when it comes to work that has been less professionalized in the care space. So that's your home care work, that's your childcare work, nannies, other domestic labor. We really still struggle to see that work as valuable. And yet when you get close to it, it is absolutely skilled work. It's complex, it's emotionally and physically taxing to do. And for many, you know, childcare, elder care work is a profession in which people have cultivated real skill and experience. Um. But we just haven't recognized that in the structures that pay for childcare and long-term care. And when you look into why this happens, you know why it's so expensive for families to access care, and yet it's still a poverty level job for many workers. You can't avoid politics and the role of public systems in driving these costs. Medicaid is the largest payer for long-term care services. State and federal regulations dictate what type of care can be provided where and by whom for both children and adults. And whether care is affordable for any of us is often dependent on the presence of public funding training programs, you know, insurance programs, tax deductions, and other laws and regulations. So this work is intensely personal, but it is also political.

Lee: 6:11

course it is. And this moment in particular, feels like it's. The culmination of so many decades of under resourcing this exact need, and I'm thinking about the baby boomers, right? This tremendously large generation that is exceedingly needing more care, right? And, and. I even think about my physician clients who are focused so much right now on how we can care for those who care for us, and thinking about wellness within hospitals. So can you talk about this moment, and of course we are recording this during a government shutdown. We are recording this at a moment when I personally just received a notice that I'm losing my health insurance, I'm having trouble scheduling my surgery like. This moment feels really scary angelina.

Angelina Drake: 7:06

It absolutely is. And your story, Lee, is one that I have been hearing from so many people in my life, uh, through protect our care through the work that we're doing there. Um, this is a really. Unique and scary moment. Now, the healthcare system and certainly long-term care and childcare have been fragmented and challenged and imperfect for decades. But what we are facing right now, going into 2026, is the enactment of a budget bill that cuts$1 trillion from Medicaid. A bill that will make care less affordable for families, and that is already causing hospitals and long-term care facilities like nursing homes to close across the country. These facilities are looking at that change in rates. They have to set their budgets well ahead of time and they're not able to stay open. That is affecting access to care for everyone, whether you rely on tax credits or any other public marketplace for your healthcare or not, and then. We are also right now failing as a country to extend really critical tax credits that have allowed people to afford healthcare through the Affordable Care Act marketplace. Millions of people will not be able to afford. The rate increases that are happening right now, folks like you are getting those notices and seeing that their premiums are going to double or triple, and that's just not sustainable for working people in this country, and when we will have fewer people using those plans and able to access care. That creates costs. Uninsured people not taking care of their health or relying on emergency room care, for example, will affect all of us, including those of us who are fortunate enough to be on a private insurance plan. Those rates are going to go up regardless because of the way that these systems interrelate. And so this is an issue that truly will affect everyone, especially as we go through these next few years, and we are looking for leadership. To take action here. This is not new information for people who are in public service. They knew this was happening. Many people voted to make these things happen, and so this is a moment where a lot of us are calling for political accountability.

Lee: 9:25

You have such a unique background, Angelina, that fe feels like you are especially primed uniquely for this moment. Thinking about your history as a direct care worker, I, I've known you. Working as chief of staff in organizations, you went through a period of working around voter engagement, and so thinking about this as a hugely intersectional issue, you know, I look on. Out in my community and there's been massive housing displacement leading to people then losing their health insurance. And oftentimes this is all culminated around health challenges specifically, right? And people not being able to get the medical care they need. People being bankrupted by our healthcare system. And so you have such a unique perspective here, thinking about a macro level of how we can actually. Change this. And what do you think we need as a society on that macro level?

Angelina Drake: 10:26

This is a big question. Uh, on a macro level, we need public investment in care. Uh, the private sector has not proven itself in this field unless you are talking about private care services. That serve only the richest among us. We've made calculations as a society that we will invest in things that benefit everyone. Uh, while you know, I'm a daughter of a public school teacher, I'm aware of the flaws in the US education system. That system exists and it is there for us from approximately ages four to 18. We don't have a comparable system to take care of people through the, the other parts of the lifespan, especially for. End of life aging and disability care, and this is why you see that care work. You know, the profound benefits of it, the agonizing challenges of finding and paying for it, and the toll and rewards of of being a, a care provider. These are really under acknowledged, but they are universal experiences and I believe a very politically powerful undercurrent in society. We are not. Traditionally comfortable as a culture talking about aging, illness, disability, disease, you know, death, right? We, we think it's our fault and that we uniquely face these challenges, and that's potentially by design. That care has been privatized in that way. And yet we all need care. And the challenges we are talking about right now are shared by people at almost every level of the income scale when it comes to long-term care. For example, uh, many people who would consider themselves well off or, or upper, upper middle class, you know, cannot afford or will have their generational wealth spent down just trying to care for their aging family members and their parents. This is really an issue that goes up and down. Income scale, and I see a lot of potential in that. I think care, if we talk about it, if we open up this conversation in ways that are starting to happen, could be this very powerful undercurrent to mobilize the electorate and to get folks to think about what kind of practical political change they want. It's an everyday economic issue. Uh, protect our care. We say it's a kitchen table issue that. Takes over the kitchen table. Uh, so I think we all have a stake in this work.

Lee: 12:52

A hundred percent. And even what you said about how much this work is under acknowledged and that we all need this care, it makes me think about these bigger societal issues that make us not talk about death and not. Acknowledge the fact that a lot of us will be disabled within our lifetime. Right? This is really a spectrum. It's not really if it's when, and even my mom has terminal cancer and she's been meeting with a death doula, and it's really interesting, like what is it about our society that makes it hard to talk about these topics? Do you think?

Angelina Drake: 13:32

Some of this we are, we just absorb norms in our culture, and, and there are cultures that have, uh, more practice bringing aging relevance into the home. Making it clear to everyone of every generation what challenges come with that work, uh, if it can vary per culture. Some of these questions are absolutely existential and have to deal with our own mortality. They're, they're big, difficult questions. And I really wanna give folks, um, a break here. You know, if they're not comfortable talking about these topics, because they can be extremely challenging. Yet once you find a space where you can talk about family care challenges? In my experience, it's hugely liberating. You hear how common these challenges are when you talk to workers, especially those who do some of the most poorly compensated care work in our culture. Again, childcare and elder care workers primarily, they. Respond, um, in such profound ways to being asked about their story, to, to having this work acknowledged. And it's a real feature of how under acknowledged it is that we don't have those stories lifted up. And, and I would say it's very similar for folks who struggle with. Chronic disease or are just, um, older and feel like they're not acknowledged in society, they're not asked to tell these stories. And the more we're creating spaces where stories can be told, a lot of what we do at Protect our Care is elevate storytellers. These are everyday people who talk about the role of health coverage and affordability in their lives and how that shapes their opportunities. We make sure that. They are speaking to elected officials, that they are covered in news media and national narratives about this work and that this conversation is not one that stays at a theoretical level or stays with the people who have the most power.

Lee: 15:36

Yeah, even what you're talking about of, you know, with people losing access to health insurance, they are going to be less likely to preventative care. They're maybe not going to schedule that doctor's appointment they need or that surgery that they know they need to have. And I can, I can't stop. Seeing the ripple effects of this Angelina and even a generation down the line, that's what scares me is the impact systemically of us not caring for ourselves. And I, I'm really. An agitator. I think when it comes to this question of, you know, do we burn it down or do we try to rebuild it? How do we build political will? How do we work with the current system? How broken it is, you know, where do we move forward? What's the levers that we can pull in this moment?

Angelina Drake: 16:33

Building political will is exactly it. This is where I have focused my work and my career personally. In 2022, a lot shifted for me. This was the year of the Supreme Court's Dobbs decision overturning Roe v. Wade, that removed vital protections and my, you know, rights that I had to my own bodily autonomy. And these are rights I'd known my entire lifetime. And it really made me think about how fragile our choice whether we want to be caregivers is. And this 2022 was also the year that the Uvalde shootings happened. Underscoring the horrific realities that, and fear that so many parents face raising children in an era of senseless and unaddressed gun violence. And then I also had the radicalizing experience of being pregnant and giving birth that year. And I did so like everyone does in in an economic system. And. For some of us, an employment environment that is not at all set up for the realities that pregnant folks and parents go through every day. And also that year, the care agenda, which heading was a culmination of many years of advocacy by the Care Justice Movement, and it was an agenda that was originally built into the build back better legislation that would provide improved funding, uh, for both workers and families to approve. To access childcare and long-term care. This care agenda was removed from the build back, better legislation before it passed as the result of one member of Congress whose vote this package needed one elected official. And so it became piercingly clear to me that. We could continue to talk about the value of care and produce plenty of content and what it would look like to recognize that value in our society. But if we don't have elected officials today who understand care and are willing to care about care and make decisions to improve healthcare, affordability, and options for their constituents. Nothing is going to get better. So I personally became increasingly motivated to impact more direct levers of political change. It's when I joined the Analyst Institute, which is a, an infrastructure organization that provides research and evidence best. Evidence backed best practices that fuel the efforts of thousands of people who work to educate and engage voters or win political campaigns. And so I got really deeply engaged in this question of, you know, what good is all this knowledge and opinions that we have of, if it's not actually reaching folks on the ground who can create political change and build the will to make sure that we are electing folks who. Care about the issues that impact our lives. And so it, it became clear to me, I would say, especially in the last few years, that we need to focus on the electorate and take the electorate seriously. This is what democracy requires, is that we are able to understand what it takes to build political will in this country and. Make sure that we are building political power, and I believe in doing that through the means, through which power is being wielded or taking away from people right now, which is the systems we have. This is the role of elections, but also the role of organizing, leadership development, um, other work that is primarily people talking to each other. In real life, going out there and taking action, uh, and not dismissing acts like voting or talking to their legislators or banding together to help, um, pressure elected officials. Not dismissing that because the larger system is flawed, which it absolutely is for so many millions of Americans and. I would love for us all to take more seriously the act of building political will and the political will to care for each other.

Lee: 20:46

It's really that one elected official really, that that really blows my mind one person, and that is the result of our system just being so broken and. It's also this, I can hear it Angelina, in your voice. I feel it too. When it impacts our, our bodily autonomy, right? Our literal healthcare, our children's healthcare. It, ignites a rage in me even right before we got on this call, I spent the morning on the phone with my insurer and trying to schedule a surgery that I need it. This rage around our safety and our care. I think that contributes to how hard it is for us to build this political will and find these common grounds. Right? There's a real fear and it makes it hard to think rationally.

Angelina Drake: 21:51

I think that's very fair and uh, that. Is what has motivated many people and, and those emotions have also caused some folks to opt out, right? We, we feel overwhelmed in these systems and having to separate what you personally need, you know, from. The long work of creating change and, and I think if you talk to anyone who does advocacy work, political work, um, any of this professionally or in a significant volunteer capacity, you know, they will tell you that this is the work of compromise. You know, we are approaching systems, we are trying to create influence. We have to create. Partnerships and coalitions and work with people who may be with us on one issue, but not on all of the issues. And when you get to the point of actually getting legislation built or getting enough people to vote for something you, you support, it is often the work of compromise and, and it can be slow work and. It's a really different pace and set of emotions that are drawn on from the moment when you can't get the care you need. And the moment we are seeing injustice happen, and those are such big and important feelings, and I think the challenge is to blend that, to motivate us to do that work that it takes to build political will and build political power over time.

Lee: 23:22

Yeah, it's really personal and I think that that's why it's so important and also why healthcare perhaps shouldn't be a business, right? And we should find different ways of supporting our society outside of. An attachment to capitalism and so much of this. me of our time working together too. And Angelina, you're one of my longest time clients and it is so just thrilling to hear you speak about your life's work. And you sound so confident and so crisp and clear, and it feels like this role is the real culmination of so much of your life's work. Can you talk. How you feel about speaking and your voice because you, you just speak so beautifully and powerfully.

Angelina Drake: 24:15

Thank you for saying that, Lee. It, it really means a lot. From you especially, and I valued the relationship that we've had, all the support you provided to me and I've also sent you to friends and family'cause I, um, believe so much in what you do and I've so appreciated the chance to. Work on the skillset of, of how do you communicate about yourself, about the issues that you care about? Maybe it's about the work that you do and making sure that you are heard and making sure that you can understand how we are received. Speaking as people who have not maybe traditionally been the folks to speak in society over time. Um, especially for a lot of women. And, and I see this in the groups who bring together how common these experiences are of having, um, unfair reactions to how we look or sound or the fact that we have opinions and hold them, or we are showing confidence and, uh, a word like. Passion for what we do. This word that can be turned into pejorative and used against primarily, you know, women and non-binary folks in society. Um, you are, your support has been so helpful in. Recognizing those forces and empowering people to speak to who they are, um, what they know to be true about themselves, but also how to move through a world that you are realistic about. You know, is, is a world that is set up to silence a lot of those voices and how can we connect people? I mean, I think power is largely built through story. Letting people tell their story is so critical. I think data is really important as well. I usually say story and data together have have led to the accumulation of power in different areas of society. And when you are providing those tools to folks like us to be able to do what we can to contribute story, to understand how we improve and communicating our passion, our message, our vision over time. Um. It's power building of a different sort, and I'm so grateful to have been on the receiving side of that with you.

Lee: 26:34

I love that Angelina, and when I think about an empathetic leader, and that's really the people I love supporting my. Most, I think of you and empathy has been a part of your work and at the front of your work for as long as I've known you and. I talk often about how empathy can be really weaponized against people in toxic environments and in a lot of our culture, and you have really just channeled your empathy and used it as a leader. And also in thinking about your advocacy work and now the way that you engage donors. And I'd love to hear. Has empathy been conscious for you? Do you think about that as a part of your strengths?

Angelina Drake: 27:22

I see political work as a way to reduce net suffering in society. And so at the base of that is absolutely, it's empathy. It's it's wanting to care for others. It's appreciating how you've been cared for or understanding where you haven't been cared for and wanting folks to have. The most positive experiences that they can as they go through this life. Um, and I think political power, you know, is necessary to reduce harm and create good point blank. And when we see that and we, and we frame things that way, there's a real opportunity to bring empathy into it. And a democracy power requires public support. And so I, I've, I think I've recognized this most when I realized we were. Losing empathy in the ways that we communicate with each other if we are impersonal. Communicating primarily through digital means. I think we've all seen in social media how empathy can get lost and how true connection. Is not always at the center, especially of political conversations that happen on those platforms. Um, I'm about a year away from social media platforms myself, and it's been pretty powerful to see that difference and see. On one level, just getting my brain back how much I've been able to do, but also the difference when you need to rely on more personal connected forms of communication. And when we're talking about care work, I mean, empathy is absolutely at the center of that. And I think, you know, hair. Is an opportunity to connect us to other people. It's an economic and a social story. We know that care costs can be crushing for families. The jobs can be really difficult and hard to stay in, and yet. Care is also the stuff of life. It's where we make profound connections to others. On a personal level, I, I think it's the most direct act of change you can take to improve someone's day is to care for them. And when we're able to change the circumstances in which care takes place, right? When we have affordable, accessible, and good quality care in our society, we're imp improving the futures of everyone around us. And it's an empathetic act ultimately.

Lee: 29:45

It is the most important thing that we can focus. Son right now, and I'm so grateful for the work that you do. I'm so grateful for your exact expertise, Angelina, because your expertise is what we need right now. We need to be building collective care. We need to be building community care, and I love thinking about that through the lens of political will and power. Angelina, we've talked about these big macro forces and it can all get really existential, and at the end of the day, we are individuals in our communities who are having to face everyday realities. And so what can we do on the daily to support ourselves, to support our communities, and to build a care economy?

Angelina Drake: 30:36

So I think if you're seeking change. For a policy, maybe this is laws and this is what gets funded for a candidate or party for who gets represented in our politics. It's really important to respect and respond to. The electorate to understand who else you know needs to get involved. Politics is a game of addition, and so I think one of the most important things we can do is talk to other people about the issues that are driving us and about specific ways we might want to make change and approaching those conversations in as inclusive a way as possible. I think care is, in my experience, a fantastic way to connect with. All people of all backgrounds, beliefs and experiences. You know, if we are all lucky to live long lives, we will need care at some point in time. Most of us have had to coordinate it for another family member at minimum. Talking about those experiences is really critical and I would love if we are also normalizing the. Act of taking advantage of the the levers of power we do have. So talk to people if you're going to vote in a local election, talk to them. If you're going to vote in a national election. Talk about how you are communicating with your elected representatives about these issues. Talk about how you're providing a space of community for people to share some of their frustrations with the challenges that they are going through. Look for the folks who are lifting messages up and join them. As much as these conversations can happen in person and within your sphere of influence, people respond best to messages from folks they trust and know. And I think the more personal we can make these conversations, the better and. I would just say to do what you can on the daily to positively normalize the act of acts of taking action, right? Making sure that we are, uh, not fostering cynicism or allowing folks to dismiss the entire system because of the challenges we're all facing, which is so. Rooted in, in values that I really do understand. Um, but we also need to make sure we're looking out for one another. And sometimes that's taking 15 minutes an hour depending on where you live to vote in a local election, uh, to meet up with some people and talk about what they're facing, to look around and see who else is speaking up for your issues in your community.

Lee: 33:14

It's so important what you're saying of just talking to each other, Angelina, and I totally agree because here in my community I'm hearing a lot of. Fears of apathy and disengagement and shutting down, frankly, because of the overwhelm. And so that feels like an amazing note to end on of talking to each other, being able to activate our voices in caring for ourselves and each other. So Angelina, I'm so grateful for your work. I'm so grateful for this conversation. Thank you so much for having it and for taking the time.

Angelina Drake: 33:55

Thank you, Lee.

Lee: 33:56

To learn more about Angelina's work, you can visit protect our care.org.