Home care workers in New York City have embarked on a hunger strike to abolish 24-hour shifts. These shifts are associated with chronic pain, injury and insomnia, and workers are paid for only 13 of the 24 hours in each shift. Together with supporters, the home care workers have held at least six protests outside City Hall over the past month. Their resort to a hunger strike, which puts their health at risk, shows how intolerable these shifts are and how determined the workers are to eliminate them.
The home care workers hope to pressure the City Council to vote on the No More 24 Act, which would prevent home health agencies from scheduling shifts of longer than 12 hours, as well as shifts that total more than 12 hours in one 24-hour period. Last month, Council Speaker Julie Menin, a Democrat, promised the home care workers that she would bring the bill to a vote in April, but she missed the deadline to do so. In theory, the bill could be brought to a vote during a City Council meeting on April 30.
New York City is home to about 200,000 home care workers, according to a 2023 report from the comptroller’s office. About 89 percent of these workers are women, 71 percent are immigrants and more than half are black or Hispanic. Home care workers help elderly, ill or disabled patients with activities of daily living such as personal care, meal preparation and transportation. They often must lift patients without assistance, which contributes to injury and chronic pain.
During a 24-hour shift, three unpaid hours are set aside for a worker’s meals, and eight unpaid hours for sleep. Nevertheless, the worker must always respond to the patients’ needs.
“Every time I ate, I had to at the same time take care of the patient,” former home care worker Xue Zhen told The Indypendent. “At nighttime, we had to take care of the patient. So, we did not have continuous sleep; often interrupted. We had to wake up a lot. For long-term, that also became a disease, insomnia. Even though I don’t work anymore, I still have problems with sleep.” Home care workers also have reported weight loss.
This hunger strike is not the first for New York’s home care workers. In March 2024, they conducted a hunger strike to force a vote on an earlier version of the No More 24 Act. The bill was introduced in 2022 and has undergone minor changes. After five days, the workers ended their previous hunger strike without a vote from the City Council, which has long been dominated by the Democrats.
In the past two years, the City Council has held no votes on the bill. Its only action was to hold a committee hearing in February 2026 at which workers, health professionals and supporters testified in favor of the bill. Since the hearing, the City Council has taken no further action. This history illustrates that, like the Republicans, the Democrats are more attentive to the needs of the healthcare companies and Wall Street shareholders than to those of highly exploited essential workers.
Many of New York’s home care workers are members of 1199SEIU, which has done nothing to help them fight against intolerable conditions. In fact, the union apparatus initially opposed the No More 24 Act, contrary to the interests of its own members. The leadership changed its position, however, when the cap on the work week was raised to 56 hours. But 1199SEIU bureaucrats did not attend a rally that the workers held during their 2024 hunger strike.
During the past two years, the union has not called any strikes, organized demonstrations against 24-hour shifts or applied any pressure on the City Council to pass the bill. Within New York’s five boroughs alone, 1199SEIU claims 200,000 members who are healthcare workers. The union has refused to mobilize this tremendous power to fight for the home care workers.
Though they claim to oppose 24-hour shifts, officials of 1199SEIU are unhappy with the No More 24 Act because they estimate that replacing each 24-hour shift with two 12-hour shifts would cost Medicaid an additional $460 million per year, which would be paid by the state and federal governments. Nothing could expose the bureaucracy’s character more clearly. The source of the additional money for 12-hour shifts is not workers’ concern; their urgent need is to abolish the torturous conditions over which they have been willing to wage two hunger strikes. The union bureaucrats’ objections prioritize fiscal rectitude and governmental procedure over their members’ health and well-being. No organization that genuinely fought for workers’ rights would take such a shameful position.
The union bureaucrats also have financial ties to the home care agencies. Together with the companies, union representatives jointly administer the 1199SEIU Home Care Industry Education Fund, which ostensibly is used for training workers. Union representatives also operate health benefit funds and pension funds. These are massive financial institutions that require administrators, legal staff and other personnel. The top administrators of these funds enjoy six-figure salaries and significant institutional power. The 1199SEIU apparatus does not want to jeopardize the material advantages they gain from these responsibilities.
The highly exploited home care workers are showing tremendous courage by conducting a second hunger strike, but the experience of the past two years demonstrates that they need a new strategy to win humane conditions. The 1199SEIU bureaucracy will not lift a finger to aid these workers. On the contrary, it will continue to isolate them and block an effective fight. The Democrats at the city and state levels have likewise shown complete indifference to the home care workers’ lives.
The home care workers must establish rank-and-file committees outside the influence of the union apparatus and of both capitalist parties. These committees, which must be under the workers’ direct and democratic control, are the means through which the workers can develop a fighting strategy and appeal to other workers for support. Moreover, the fight against grueling shifts inevitably places workers in conflict with the system of for-profit medicine and the financial oligarchy that benefits from it.