DES MOINES, Iowa -- As a local advocate for Americans living with disabilities, Emmanuel Smith does not mince words when it comes to the upcoming caucus.
"I think it's important for people to understand it's not eight people in a one-room schoolhouse and cornfield somewhere. These are packed, packed, packed gymnasiums, government buildings, really anywhere that we can find to pack people in. And it's two hours of that and it's loud and it's frustrating and people are confused," Smith, who has brittle bone disease, suffers from chronic pain and uses a wheelchair, told ABC News.
Smith added that there are concerns about people with all kinds of physical, mental and emotional disabilities being disillusioned and discouraged by the caucus process.
Unlike a primary where voters cast traditional ballots from home or in a booth, the Iowa caucuses require voters to show up in person, talk with their neighbors and wait to be counted. Everyone in favor of one candidate moves to one corner -- those who like someone else -- stand across the room.
There is debate and regrouping through multiple stages. It can take hours.
"When you have chronic pain and fatigue, that's not particularly fun. And I'm worried most about all the people who don't caucus because of barriers like that." Smith said that last year it took over an hour to get to the caucus site from work because of limited transportation --- a physically exhausting endeavor by the end of the night.
To Smith, the caucus system, as designed today, is disenfranchising too many of their neighbors. Unless Iowa and its residents are committed to making it easier for everyone to participate, he said, the state should not continue to have the highly coveted role of voting first.
"If it's true that most Iowans value our first-in-the nation status over inclusion, then we don't deserve to be first anyway," Smith told ABC News during an interview in downtown Des Moines earlier this month.
In 2016, there were more than 16 million voters with disabilities participating in the general election. Over 300,000 people with disabilities live in Iowa alone.
After the 2016 elections, Democratic National Committee leaders were receptive to concerns that the Iowa caucuses posed unique barriers. In fact, the national party discouraged other states from holding caucuses, though two of the first three states to vote this year -- Iowa and Nevada -- still have them.
However, any changes to the traditional caucus system in Iowa, such as possible mail-in or remote voting, could make voting day look more like a regular primary and that has ramifications for the entire calendar. New Hampshire, for instance, which currently votes second, is dictated by state law to host the first true primary in the nation.
The Iowa Democratic Party has made changes to bring in more voters. Voters can now bypass check-in lines on caucus night through a pre-registration process, request accommodations and attend caucuses at more convenient sites.
"Expanding participation has been at the heart of all of these changes and we will continue to work to increase accessibility on caucus night," Iowa Democratic Party Communications Director Mandy McClure told ABC News in a statement.
"A lot of the caucus locations last time were NOT accessible," Jennifer Laszlo Mizrahi, president of RespectAbility.org told ABC News in a statement. "The Democratic Party is working to resolve this for this election, as are the democratic campaigns to make themselves accessible as last time there were so many problems."
Nyle DiMarco, a past winner of America’s Next Top Model who is deaf, has helped the Democratic Party get out the word to make sure accessibility needs are met.
After tough experiences caucusing in the past, Smith also pointed out that in addition to people with disabilities, those who work evening shifts or public-facing jobs may also be discouraged with the caucus process.
Karen Kedrowski, director of the Carrie Chapman Catt Center for Women and Politics at Iowa State University, told ABC News, "There's been a fair amount of criticism about Iowa being the first in the nation. It's a small state -- 3 million people. It is not as diverse as other parts of the country."
However, she argued that participation among registered party members remains high and Iowans take their role of being the first contest in every presidential cycle seriously.
"As I observe and talk to Iowans, they don't think about who is going to be the best president for what I want. They're asking the question about who is the best president for the United States? You know, who is the best person who can shake things up?" she said.
Last year, the national Democratic Party Committee halted plans in Iowa to launch an innovative "virtual caucus" that would have allowed people to participate remotely.
"Disabled people in Iowa were really, really, really, really excited about the virtual caucus," Tucker Cassidy told ABC News at his home in Waterloo, Iowa.
He said it would have been a "fantastic" way for people with a variety of disabilities -- from autism to other sensory sensitivities and physical challenges -- to take part.
While in college 15 years ago, Cassidy was accidentally shot in the neck by a friend when the two were looking at an antique handgun. The bullet hit an artery and caused a major spinal cord injury. Now, a quadriplegic, he requires at-home care, extensive nursing and support to get around town.
By the middle of January, he had attended dozens of campaign events and was still largely undecided on which Democratic candidate he planned to support.
Cassidy was quick to defend the caucuses during his interview with ABC News. He said that for people with disabilities, the larger-scale neighborhood meetings can be especially valuable. It forces interaction between community members who may not otherwise cross paths. He felt it was important last cycle that he was seen and heard at his caucus.
Cassidy listed what makes the caucuses special: the public debate, discussion and collaboration over which potential nominees to support.
"The nuts and bolts of it ... being grassroots ... trying to convince somebody that your candidate is a great candidate," he said.
However, he pointed out that there are logistical issues that people with physical disabilities face when considering attending any event, including a party caucus.
"When you're a disabled person, you're going to have to worry about if you're going to get home in time for your home health aid to be able to put you to bed."
"[At a caucus] you worry, 'am I going to be able to find a spot? When we do realignment, am I going to be in everybody's way? Will I be able to move? If I raise my hand, will people be able to tell? Is my vote going to get counted?'" he added.