Better health = more democracy
by Tom Sullivan
As we brace for another day of impeachment drama, Eric Levitz at New York magazine’s “Intelligencer” offers support for why your health care is another key 2020 election issue.
One of the classic arguments for having strong unions is that not only union members benefit from their bargaining power, but nonmembers as well. Strong unions constrain income inequality generally.
Levitz suggests universal health care has similar effects. Examining states that implemented Medicaid expansion with neighboring holdout states provides “a nifty natural experiment for assessing the impacts of expanding access to public health insurance.” Comparisons demonstrate Medicaid expansion reduces premium costs for non-beneficiaries as well as increasing self-reported health and financial well-being.
But more than that:
Border-county studies have also yielded a less intuitive benefit of expansion. 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.
Just why Medicaid expansion increases voter participation is unclear, Levitz writes. Beside offering voter registration as part of signing up, perhaps providing nonvoters with a tangible government service of benefit to their lives gives them a greater stake in the political life of the country than evanescent promises of more “freedom.” Levitz adds, “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.”
No wonder Republicans oppose universal health care.