This story first appeared in How We Care, a weekly newsletter by Spotlight PA featuring original reporting and perspectives on how we care for one another at all stages of life. Sign up for free here.
Caregiving has not emerged as a major issue in this year’s closely watched contest for one of Pennsylvania’s U.S. Senate seats, which has largely centered on the economy and foreign policy.
But where Democrat Bob Casey and Republican Dave McCormick stand on reproductive health, child care, and other issues impacts all Pennsylvanians, as everyone relies on caregivers at various times. Many people also provide care, or could in the future.
McCormick, a Washington County native, has never been elected to public office. However, he held several positions in the George W. Bush administration, including in the U.S. Treasury and the Department of Commerce. He is also a combat veteran and former hedge fund CEO with a Ph.D. in international relations from Princeton University. This experience informs his economic and foreign policy positions, but does not reveal much about his views on caregiving.
Due to Casey’s long tenure in public office, Pennsylvania’s senior senator has a lengthy record on topics that affect caregivers. This includes his longstanding advocacy for the Children's Health Insurance Program.
Below, we explore the major party candidates’ positions on multiple caregiving topics. Spotlight PA reached out to both campaigns, but only Casey’s responded to questions via email.
Reproductive health
Most Americans believe there are circumstances when abortion should and should not be legal, according to a 2022 survey from the Pew Research Center. In this way, Casey and McCormick resemble most of the country — though they disagree on several key points.
Casey was raised Catholic and has called himself a “pro-life Democrat.” He told Politico in 2018 that though he opposes abortion, he aims to support women and children both before and after birth. That year, he voted to ban abortion after 20 weeks of gestation. The bill was introduced by U.S. Sen. Lindsey Graham (R., South Carolina) and backed by then-President Donald Trump.
In the years since, Casey’s stance on abortion appears to have changed. In 2022, he said that the U.S. Supreme Court overturning the constitutional right to abortion put women’s lives at risk.
“Our daughters and granddaughters should not grow up with fewer rights than their mothers,” Casey said in a statement at the time. He later voted in favor of the Women’s Health Protection Act, which would have codified the right to abortion care.
Mary Ziegler, a leading expert on abortion law, told the Associated Press earlier this year that Casey’s shifting position may have been influenced by the anti-abortion movement gaining footholds among Christian conservatives and Republicans.
Casey’s campaign did not directly respond to Spotlight PA’s inquiries about whether he still supports a 20-week ban. But a spokesperson did say that the senator wants to preserve clinicians’ ability to send abortion medications through the mail. However, Casey is not a co-sponsor of legislation that would repeal the Comstock Act, a 19th-century anti-vice law that reproductive advocates fear could be used to ban the mailing of abortion medications.
For people who live in communities that lack abortion providers, the revival of Comstock could profoundly limit their ability to access abortion care. Nearly 1 in 5 abortions in the U.S. is provided via telehealth, according to a May report from the Society of Family Planning, which advocates for abortion access.
Dave McCormick also describes himself as “pro-life.” When a draft of the U.S. Supreme Court’s eventual decision to remove the right to abortion was leaked, he said the ruling would be a “huge victory for the protection of innocent life.”
But McCormick does not support a national ban, and believes state legislators should decide abortion policies. He thinks any legislation that prohibits abortion should make exceptions for rape, incest, and when the life of the mother is in danger.
McCormick says he supports restrictions on so-called late-term abortions. "Late-term," according to the American College of Obstetricians and Gynecologists, is a phrase with "no clinical or medical significance."
McCormick’s campaign did not respond to Spotlight PA’s question seeking to clarify his definition of late-term abortion, though he did tell the Washington Examiner that he does not support abortions that occur after fetal viability. Viability is also a contested term, according to ACOG, which explains that more factors than gestational age determine whether a premature infant lives.
The campaign did not answer whether McCormick favors a prohibition on mailing abortion medications.
Some anti-abortion groups oppose in vitro fertilization because the process creates a surplus of fertilized embryos that are sometimes destroyed after a patient has conceived and given birth.
Last year, McCormick’s website said he believes life begins at conception; that language has since been removed. But McCormick says that part of his ”pro-family agenda” includes advocating for IVF treatment, and has promised that as a senator, he’d oppose any effort to restrict it. He has proposed creating a $15,000 refundable tax credit for families seeking medical assistance to conceive a child.
McCormick wrote in a March op-ed that as CEO of hedge fund Bridgewater Associates, his team felt obligated to provide financial assistance to employees trying to have children: “That’s why as a company we helped pay for fertility services like IVF, which are often not covered by insurance and can be prohibitively expensive.”
In the same op-ed, McCormick said contraception should be more accessible and affordable. He reiterated this in June while speaking to a crowd in Delaware County, saying there should be legislation to expand access to contraception so people can have children “when they’re ready.”
Casey also supports expanding access to birth control and in June voted for legislation that would prohibit states from banning any type of contraception approved by the Food and Drug Administration. The bill did not reach the 60-vote threshold.
Last week, the Right to IVF Act, which Casey co-sponsored, also failed to get 60 votes. The bill would have protected and expanded access to fertility treatment, including IVF.
Child care
Parents can spend thousands of dollars a year on child care.
To make that care more affordable, Casey proposed a bill that would increase the amount a family could claim on taxes for child care costs. Also, the tax credit would become refundable, meaning parents could get a refund even if their liability is $0. Currently, the tax credit is nonrefundable, and therefore is more likely to benefit families with higher incomes.
McCormick wants to expand the federal child tax credit, which currently provides up to $2,000 per qualifying child to offset the cost of raising them. The Republican wants to raise the maximum amount to $4,200 per child, depending on their age, and tie future increases to inflation. Casey also backs tying the tax credit to inflation.
McCormick also has said he wants to give parents tax-free savings accounts that they can use to pay for up to $10,000 per year in child care costs. And he has argued for increasing funding for a federal program that provides financial aid for child care to low- and middle-income families.
The average annual cost of center-based child care for toddlers in Pennsylvania is $11,346, according to a 2023 report from the Annie E. Casey Foundation, a youth advocacy charity.
While a lower tax bill can help alleviate the economic burden of child care, policy experts tell Spotlight PA that tax credits alone are an insufficient solution. They explain the crisis is a supply-side problem: Caregivers earn modest salaries, which drives many of them from the industry.
Casey’s campaign cited his support of a bill that would provide states funding for grants to providers in order to raise wages.
McCormick has said he favors federal assistance programs that incentivize states to create policies that make it easier for faith-based and community organizations to open child care centers.
Insurance
Some 690,000 Pennsylvanians have medical debt, according to a recent study from the Peterson Center on Healthcare and KFF. Health insurance can protect people from huge medical bills and help them access care they otherwise could not afford.
A spokesperson for the Casey campaign told Spotlight PA that the senator believes every American deserves good and affordable health care. They cited legislation introduced by Casey that would automatically enroll all children in Medicaid, and his work to cap annual out-of-pocket prescription drug costs at $2,000 for older adults with commercial Medicare insurance.
Casey supports giving Medicare the ability to negotiate drug prices, and McCormick says he’s skeptical of this — though the Republican does favor Medicare’s recent $35 copay cap on insulin.
In September, Casey introduced legislation that would make it easier for older people with disabilities to maintain Medicaid coverage. Other recent bills that Casey has sponsored would reduce the cost of mental health care for military service members, help older adults with Medicare coverage get residential addiction treatment, and expand access to doula and midwife services through Medicaid.
McCormick’s campaign website offers little on insurance, though it does say he supports expanding access to quality physical and mental health care for veterans. Additionally, the Delaware Valley Journal reported that during an event in June, McCormick said he wants to expand mental health care by “getting rid of Medicaid rules that constrain access to psychiatric [help]."
McCormick has also said he wants to extend Medicaid coverage for one year after parents give birth.