The ideal Iowa caucus is a crowded room of people holding a spirited argument about politics, electability, and passionately held beliefs. But to Iowa caucus-goer Emmanuel Smith, who has osteogenesis imperfecta — otherwise known as brittle bones disease — the prospect of jostling over caucus votes is terrifying.

Smith suffers from persistent chronic pain and fatigue, and being in crowded spaces is risky. When they participated in the 2016 Iowa caucuses, the very layout of the room presented a challenge.

“If somebody backs into my wheelchair and falls and topples me, I’m going to get very badly injured,” Smith, an advocate with Disability Rights Iowa, told Vox in a recent interview.

If Smith lived in another state, it would be easy enough to cast a primary ballot in-person or vote absentee by mail. But with the Iowa caucuses, voting is an in-person, hours-long event where Iowans have to physically travel to one of the state’s 1,678 precincts to participate. Voting in the caucuses is a physical act — congregating with other people who support the same candidate.

This is inherently limiting. Just 15.7 percent of Iowa’s voting-eligible population participated in the caucuses in 2016 — a fraction of the 52 percent of New Hampshire voters who turned out a week later for that state’s primary. Even during Iowa’s record-setting turnout of the 2008 elections, it was still just 16.1 percent.

Access to the caucuses has long been a problem in Iowa, and not just for those with disabilities. Think of the elderly, those who don’t speak English, parents of young children who can’t afford a babysitter, or folks who simply can’t take time off work to go and caucus for hours.

“This system was designed for 40 people in a living room,” said John Deeth, a longtime party activist and member of the Johnson County Democrats executive committee.

Smith, for one, would prefer a system that gives more voters access — even if it means switching from a caucus to a primary and giving up being first.

“I don’t think we should be able to trade away the ability for people to participate in order to preserve the status quo,” Smith said.

Iowa’s low turnout has to do with accessibility

The caucuses have grown exponentially from the living room days of the 1970s when party leaders mainly controlled the candidate selection process. But as power shifted to voters and the caucuses became more of a draw, finding a big enough place to fit everyone turned into more of a challenge.

“We do anticipate record crowds and with that comes challenges. The challenges are size and parking,” said Ed Cranston, chair of the Johnson County Democrats in Iowa. Johnson County is ground zero for spatial problems; it’s home to Iowa City and the University of Iowa, meaning high turnout from students and faculty.

Deeth is the one tasked with finding a big enough caucus site for the 50-plus precincts in Johnson County. Every four years brings challenges; for instance, this year Deeth was turned down by a church and a high school that scheduled a wrestling meet on caucus night, “so we’re in an elementary school instead of a high school.”

His search for a room big enough to hold enough caucus-goers encapsulates a problem in certain parts of Iowa; Democrats want more folks to turn out, but sometimes there’s literally not enough space to hold them.

“If less people showed up, I wouldn’t be upset,” said Deeth. “It’s not that I want less people to participate, it’s just we’re straining our capacity. We can’t build buildings. We can’t build parking lots. We are doing the best we can with the resources we’ve got.”

After the Democratic National Committee nixed the Iowa Democratic Party’s plan for a virtual, tele-caucus this year, the state’s Democratic party has allowed separate satellite caucuses in an attempt to boost accessibility. Many are happening in nursing homes around the state to accommodate the elderly. Smith, the disability rights advocate with brittle bones disease, is holding one in their apartment building. Some caucuses are offering child care on-site, as the Gazette columnist Lyz Lenz wrote for the Cedar Rapids-based newspaper.

Still, there have been lingering complaints from caucus-goers that the satellite caucus was poorly advertised and hastily arranged, and put the burden on individuals to organize.

“We don’t think there’s systemic approaches to solving the inaccessibility of the causes for many marginalized people,” said Jane Hudson, executive director of Disability Rights Iowa. “The parties keep giving these bandaged kinds of fixes that have a lot of problems themselves. But they’re disenfranchising a lot of people.”

In a statement, the Iowa Democratic Party said they’re working to make the Iowa caucuses more accessible, with the addition of satellite caucuses, early check-in at caucus locations, and a reduced realignment time to make the whole process shorter.

“This year’s caucuses will be the most accessible ever because of the tireless work of disability activists and the groundbreaking changes the Iowa Democratic Party has put forth,” said Catherine Crist, the Iowa Democratic Party disability caucus chair. “While our work is far from finished, our years-long effort to shift the culture and expand access for people with disabilities has borne historic progress.”

Some Democratic activists told Vox the party is aware of the issues, and trying to fix them.

“The Democratic party is keenly aware of issues of access,” said Sue Dvorsky, a former Iowa Democratic Party chair and longtime party activist. “We know the caucus is not an election, it is not a constitutionally protected right. It is a process where we begin to elect our delegates, it’s not our primary.”

Dvorsky believes the current Democratic party officials are doing the best with what few resources they have. While she and many others think the caucus system should stay, Deeth thinks the persistent accessibility issues with the caucus mean it’s time to seriously consider moving to a primary system.

“I just hope that when it’s over, we take an honest look at ourselves and decide, can we really continue to justify this?” Deeth said.

Update: This piece has been updated with a statement from the Iowa Democratic Party.