States Should Embrace Vote by Mail and Early Voting To Protect Higher-Risk Populations From Coronavirus

Election workers wearing gloves sort vote-by-mail ballots for the presidential primary in Renton, Washington, on March 10, 2020.

The COVID-19 pandemic poses a substantial threat to U.S. elections, as described in previous reports by the Center for American Progress. Unless officials make significant changes to state election systems before November, Americans who vote or serve as election workers will be forced to put their lives at risk in order to participate in the democratic process. And it is not just voters or election personnel who have good cause for concern. Even those who cannot cast a ballot could become ill by coming into contact with a family member, caregiver, or neighbor who contracts the coronavirus through the voting process.

Although COVID-19 affects people from all backgrounds and communities, some groups are at higher risk of contracting and becoming seriously ill from the virus, including:

  • People ages 65 or older
  • People with preexisting conditions
  • Veterans
  • People of color
  • People with disabilities

In considering best practices for administering elections during a pandemic, lawmakers must take into account the health and safety of not just those involved in the voting process but also members of entire state populations who could be negatively affected if proper precautions are not taken. In order to keep voters, poll workers, and especially populations at risk of COVID-19 safe, state and national leaders must take immediate action to fortify the voting process and protect voters and nonvoters alike.

Indeed, in-person voting during Wisconsin’s primary in early April raised concerns that in the absence of important safeguards, community spread can occur through the voting process. Despite best efforts by election officials, the state’s election infrastructure proved inadequate for accommodating social distancing and huge surges in vote by mail. Countless lives were put at risk because of these shortcomings.

By expanding access to vote by mail and implementing at least two weeks of early voting, lawmakers can protect voters and election workers—some of whom may belong to these at-risk populations—and the fundamental right to vote. In doing so, they will also help mitigate potential COVID-19-related health risks deriving from the voting process, including by diminishing the chance for community spread.

Conducting elections in the usual manner will jeopardize the health of many Americans

Although voting by mail is used broadly in a handful of places, in-person voting still remains the most popular method of casting ballots in most states and Washington, D.C. However, in the midst of a pandemic and as Americans are advised to stay home and practice social distancing, many voters must shift toward safer options.

COVID-19 can spread in various ways through usual voting processes. At polling places, individuals use pens shared by hundreds of other voters to fill out necessary forms, as well as touch-screen voting machines harboring germs from prior usage. Remaining at least 6 feet apart, as the Centers for Disease Control and Prevention (CDC) recommends during this pandemic, may prove impossible at jampacked polling locations serving hundreds of voters at a time or while waiting in long lines positioned along congested sidewalks or streets. Given the numerous points of contact with people potentially infected with COVID-19 and contaminated equipment, voters and election workers could easily contract the virus. Once the polls close, the virus could spread to others in the community, causing a full-blown outbreak.

To be sure, in-person voting options must be preserved even during a public health emergency. However, in-person voting cannot remain the default option for most Americans; a business-as-usual approach to elections risks community spread and will put many lives at stake. This is especially true for people who are at higher risk of developing severe illness from COVID-19, including those belonging to the following groups.

People ages 65 or older: According to the CDC, people ages 65 or older are “at high-risk for severe illness from COVID-19.” In fact, people belonging to this age group account for 80 percent of all COVID-19 deaths in the United States. This vulnerability is due partly to normal physiological changes, such as weakened immune systems, that come with aging, making it harder for older people to fight off the virus. People 65 years or older are also more likely to have chronic medical conditions such as heart and lung diseases, which can worsen as a result of the coronavirus. Many poll workers fall into this age group and are thus more susceptible to serious illness.

Across the United States, more than 52 million people are ages 65 or older.

Nonelderly population with preexisting conditions: Those younger than age 65 with certain preexisting health conditions are also at higher risk of developing dangerous complications from COVID-19. In particular, the CDC has identified people suffering from respiratory and nonrespiratory illnesses—including asthma, chronic lung disease, serious heart conditions, diabetes, chronic kidney disease treated with dialysis, liver disease, and those who are severely obese or immunocompromised—as being in danger of severe illness. COVID-19 can cause flare-ups or worsening of existing respiratory problems and lead to cardiac strain among people with heart conditions. Those with liver disease or chronic kidney disease treated with dialysis may have weakened immune systems and be unable to successfully combat COVID-19. This is also true of people who are immunocompromised. Myriad underlying health conditions associated with diabetes and severe obesity also leave people with those illnesses vulnerable to developing serious medical complications resulting from COVID-19.

More than 135 million nonelderly people in the United States live with a preexisting condition. 

Veterans: Given that many veterans are older or may have preexisting illnesses, they are among those groups particularly susceptible to developing serious illness related to COVID-19. For instance, nearly half of all veterans are ages 65 or older, based on projections by the U.S. Department of Veterans Affairs’ National Center for Veterans Analysis and Statistics. Younger veterans who served overseas in Iraq and Afghanistan between 2001 and 2009 are also disproportionately likely to suffer complications from COVID-19 compared with nonveterans of the same age, due to many having preexisting respiratory conditions resulting from duty-related injuries and exposures, including to open waste burn pits. Such pits, which were used by the U.S. military to burn solid waste, emitted poisonous particulates that have been linked to asthma, emphysema, and other severe illnesses; more than 203,500 veterans and service members have documented their exposure.

There are nearly 19 million veterans nationwide.

People of color: Based on the available data, people of color are being disproportionately affected by COVID-19 compared with their white counterparts. The CDC has attributed this, at least in part, to differing socioeconomic conditions as well as residential segregation, among numerous other factors. People of color are more likely than whites to work in essential, low-wage jobs that put them at greater risk of contracting COVID-19 and are also more likely to live in urban centers, where there is a higher chance of coming into contact with someone who tests positive for COVID-19. Black Americans, people who are Hispanic or Latinx, and Native Americans have higher rates of serious chronic health conditions that leave them at an increased risk of developing serious medical complications from COVID-19 and are more likely to be uninsured. Barriers to acquiring important health information and services further contribute to COVID-19’s disproportionate impact on communities of color, particularly for people with limited English proficiency and for people living on tribal lands who may lack ready access to care. Finally, the role that systemic racial and ethnic discrimination across the health care system plays in the disproportionately high rates of COVID-19 among people of color cannot be overstated.

People of color account for nearly 40 percent of the U.S. population, or nearly 130 million people nationwide.

People with disabilities: As noted by the CDC, “Disability alone may not be related to higher risk for getting COVID-19 or having severe illness.” Indeed, only people with disabilities who also have chronic or preexisting medical conditions are especially susceptible to severe complications from the virus. That said, adults with disabilities are three times more likely than those without to live with many such conditions and thus qualify as a COVID-19 at-risk group. People who rely on caregivers are particularly vulnerable, as there is a higher likelihood of coming into contact with someone who tests positive for COVID-19. People who are blind or visually impaired, or deaf or hard of hearing, may have difficulty obtaining vital public health information. People with disabilities may further be at high risk for developing more severe cases of COVID-19 because of discrimination and the various obstacles they face in obtaining medical care as well as other critical services.

Across the United States, more than 28 million nonelderly people live with a disability.

As illustrated below in Figure 1, people belonging to these groups reside in every state, often in very large numbers. This is why officials in all states must take immediate action to update election procedures in ways that protect residents’ health and safety, while fully preserving the democratic process.

Figure 1

Vote by mail and extended early voting are key to mitigating health risks

The best way to fortify elections against COVID-19 and to mitigate community spread is for states to expand access to vote by mail by adopting no-excuse absentee voting and automatically sending ballots to all qualified voters so that voters can cast ballots from the safety of their homes. Vote by mail is especially important for voters belonging to some of the at-risk groups identified above, particularly people older than age 65, those with preexisting conditions, and veterans. Vote by mail has been backed by more than 800 public health experts, who in a recent letter asserted, “In order to ensure the integrity of the electoral process and protect the public health at the same time, it is incumbent on our leaders to prepare for a Presidential election by mail, in which ballots are sent to all registered voters, to allow them to vote from home and ensure their health and safety in the event of a new outbreak of [COVID-19].”

Although vote by mail must become the default option for the vast majority of Americans during this health crisis, as illustrated in a prior CAP column, vote by mail is not an ideal or accessible option for many others. As such, even as states switch to mostly mail-based elections, in-person voting must remain available and accessible for those who need it. Indeed, preserving in-person options are especially important for some of the COVID-19 at-risk populations identified above, particularly for Black Americans, Native Americans, and some people with disabilities. Fortunately, there are ways to keep in-person voting locations safe for these at-risk populations as well as for other voters and election workers. To start with, by expanding access to vote by mail, fewer people will rely on in-person options to cast their ballots, thereby helping to prevent long lines or crowds from forming at polling places.

Another way to keep in-person voting safe is for states to implement at least two weeks of early voting, which, as described in a CAP column, “would help to reduce lines by dispersing voters across several days and locations.” Additional measures—such as ensuring that election workers receive robust training on properly sanitizing equipment; that poll locations are fully stocked with sanitary supplies that are readily available to all who enter; and that poll workers are provided with protective gear, such as masks and gloves—are also necessary.

Conclusion

States officials must not delay in implementing vital policies such as vote by mail and extended early voting for upcoming elections—nor must Congress delay providing additional funding in the amount of $4 billion as recommended by noted experts for states to make all necessary upgrades to election procedures and infrastructure in time for upcoming elections. State and national leaders have a duty to protect the populace and must honor that duty by making it possible for elections to be carried out safely and effectively.

Danielle Root is the associate director of voting rights and access to justice on the Democracy and Government Reform team at the Center for American Progress.

To find the latest CAP resources on the coronavirus, visit our coronavirus resource page.