Medicaid expansion increases voter turnout: What that means for 2020

By Health CareFOXBusiness

Health care’s road ahead after the midterms

America’s Health Insurance Plans CEO Matt Eyles discusses how the midterm election results may affect the future of health care.

When states expand Medicaid coverage, it’s almost intrinsically linked to higher voter turnout.

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That’s according to a new study published in November that found, based on the effects of a randomized Medicaid expansion in Oregon, voter turnout was higher in the November 2008 election for people who had won coverage through the state’s lottery system. That increase, however, petered out by the 2010 midterm election.

“I think this contributes a substantial piece of evidence supporting the idea that when you expand Medicaid coverage, at least in the short term, people are more likely to come out and vote,” said Katherine Baicker, a co-author of the report and the dean of the University of Chicago Harris School of Public Policy.

Given the recent statewide expansions – during Tuesday’s midterm elections that saw Democrats gain control of the House for the first time in eight years, three traditionally red states voted their Medicaid programs, extending coverage to an estimated 325,000 low-income Americans – what does this mean for 2020 elections?

It’s a weighted question, largely because there’s only speculation about why voter turnout increases, or how long that hike lasts, according to Baicker, who noted that the effect was “particularly concentrated” in men and people who were living in Democratic-skewed counties.

“You could tell lots of different stories about why that is,” she said.

Among them: Perhaps because Medicaid affects people’s health, more people vote if they feel healthier. Or, it might change people’s perception about the value of public programs and the overarching importance of the government. It could also be that people feel more financially secure and therefore more inclined to vote.

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It’s possible that voter turnout will be boosted by expansions in Utah, Nebraska and Idaho, all of which broadened coverage of the federal and state health insurance program, a provision of the Affordable Care Act, to all residents whose income is less than 133 percent of the poverty line (about $16,000 for one person, or roughly $32,700 for a family of four).

“Now how big that effect will be, I don’t know whether the effect of new coverage will persist to 2020,” she said. “It might. And we might expect it to have a disproportionate effect in men and people that tend to vote Democratic, but the duration of these effects is really an open question.”

Another study also found a correlation between voter turnout and Medicaid expansion – largely because of an increase in turnout of beneficiaries of the program, and a backlash among voters who oppose it.

"Having access to health insurance could play a role in increasing voter participation as healthy people are much more likely to vote than unhealthy people, and insurance increases people's financial stability, which also makes them more likely to vote,” the author, Jake Haselswerdt said in a statement.

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