People Have to Like This Crap: Healthcare and Voter Turnout

While many people don’t vote their immediate circumstances, we shouldn’t ignore the role good policy can play in getting voters to actually show up and vote (boldface mine):

Increasing voter turnout is hard. Robustly progressive, anti-Establishment campaign messages rarely do the trick. Well-funded registration campaigns targeted at nonvoting communities have barely made a dent. Even implementing policies that make it easier to vote — whether by increasing opportunities to register or expanding early voting — have not generally correlated with higher rates of civic participation.

But giving low-income people health care has….

A 2018 study from the political scientists Joshua Clinton and Michael Sances found that in counties with high populations of Medicaid-expansion-eligible residents, the policy’s implementation increased both voter turnout and registration in the 2014 midterm elections. A 2017 study from Missouri political scientist Jake Haselswerdt found a similar correlation between Medicaid expansion and higher rates of voter turnout at the congressional district level in the 2012 election. Finally, just this year, a study of Oregon’s experiment with expanding Medicaid by lottery (prior to the Affordable Care Act’s passage) found that the program increased its recipients’ individual likelihood of voting by 2.5 percentage points.

Data for Progress helpfully draws out the implications of these findings in a recent report. Using Medicaid’s average impact on turnout across the three studies and the Kaiser Family Foundation’s estimates of the Medicaid coverage gap in the 13 states that still haven’t implemented expansion, the progressive think tank calculates that full implementation of Medicaid expansion would bring as many as 1.3 million Americans off our democracy’s sidelines and into the electorate by 2022.

One reason, among several, for the increased turnout is that people tend to vote when they think voting will make their lives better (however one wants to define “better”):

…by providing nonvoters with a valuable government service that makes a tangible difference in their lives, Medicaid expansion may give them a clearer stake in the political process than they previously had. This would be consistent with MIT political scientist Andrea L. Campbell’s research on the development of Social Security, which suggests the program was a cause of American seniors’ high levels of voter participation, not a mere response to that participation. Which is to say, older voters did not cast ballots at such elevated rates until Social Security alerted them to the stakes of partisan conflict.

We also saw in Ohio in 2016 that people who did not vote were more likely to believe that voting wouldn’t make their lives better.

Would great policy turn turn Alabama blue in a presidential election anytime soon? Probably not. But majorities (and super-majorities) are won at the margins. Turnout, especially in off years as Virginia demonstrated in 2017 and 2019, can have significant effects.

People do have to like this crap.

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