The link between Medicaid expansion and improving the health and well-being of individuals and communities in states across the country is crystal clear, supported by hundreds of studies. But there’s growing research to suggest that Medicaid expansion has impacts far beyond just health outcomes.  

A new Data for Progress memo connects the dots between expanding Medicaid coverage and increasing political participation, pulling from a number of reports and studies that suggest the two go hand-in-hand. Data for Progress builds on the important work of researchers like Jamila Michener of Cornell University, who argues in her book “Fragmented Democracy: Medicaid, Federalism, and Unequal Politics“ that the way individuals experience Medicaid impacts their relationship to government and democracy. In Data for Progress’ memo, the thesis is even more direct: they argue that Medicaid enrollment likely increases voter registration because it creates another entry point to register while individuals are signing up for coverage. Medicaid expansion also improves individuals’ physical health, mental health, and financial security – all factors potentially leading to greater participation in the democratic process for people with Medicaid coverage.  

And of course, defending and supporting the Medicaid program – and Medicaid expansion – is an overwhelmingly popular issue, one that drives voters to the polls and remains a powerful catalyst for political participation. In fact, Data for Progress predicts that “as many as 1.3 million more Americans would vote under universal Medicaid expansion, and voter registration would increase by tens or possibly hundreds of thousands.” 

However, these findings are all the more sobering when you consider this moment in time: one in which people of color, people with disabilities and young people continue to face systemic barriers to voting and in which some politicians are pushing ahead with voter suppression agendas in states across the country.  

Our takeaway? 

State and local advocates should continue to emphasize the important connection between Medicaid expansion and voter participation and look holistically at protecting the health and rights of the communities they are advocating for. Here’s how:  

1) Creating New Partnerships Across Issue Areas 

Beyond a state’s usual health care roundtable, advocacy organizations focused on defending or expanding their state Medicaid program should consider fostering new partnerships with organizations that are leading the way on voter participation and democracy reform.  

Health care advocacy organizations could also consider broadening their own advocacy portfolio to support and stand in solidary with organizations doing voter registration work and fighting against voter suppression efforts aimed at disenfranchising people of color. For example, New Virginia Majority, a grassroots voter engagement organization, was active in the fight to secure Medicaid expansion and credits the flip of both chambers of Virginia’s legislature in 2019, in part, to the base of motivated health care voters built through such fights.  

2) Reenergizing Medicaid Supporters  

In non-expansion states where advocates have fought for Medicaid expansion for years, continuing to organize supporters around an issue that politicians have failed to take action on can prove difficult. Research like this offers a new messaging frame to reenergize Medicaid supporters and increase grassroots engagement from various constituencies.  

3) Holding Candidates and Politicians Accountable  

In poll after poll, we see that voters value Medicaid and want common sense efforts to protect and expand it. One important way that consumer health advocates, such as 501(c)(3) organizations, can elevate the importance of Medicaid is by engaging local, state and federal candidates for elected office. For example, Georgians for a Healthy Future authored a health care candidate questionnaire for coalition partners to use at candidate forums they were hosting in 2018. In Idaho, Medicaid advocates educate newly-elected officials each year by hosting health care roundtables that raise Medicaid expansion and the harms of work requirements, among other issues.  

Our Sample Candidate Questionnaire on Medicaid resource provides questions you can utilize to ask candidates about how they will protect and build on the Medicaid program in the face of threats such as funding cuts, work requirements and other restrictions on eligibility. These questions can be used or tailored to engage federal, state and local candidates in a number of settings, including candidate forums, candidate questionnaires, one-on-one meetings or during a debate. 

With these strategies, state and local advocates can ensure protecting the Medicaid program remains a hot button issue – in the community, in the State House and at the ballot box.