It’s becoming increasingly clear that Medicaid is the center of the health policy universe.
Medicaid is the largest single insurer in the United States, covering north of 70 million people with low incomes and disabilities, and is responsible for most of the 20 million additional people covered by Affordable Care Act. The ACA expansion established Medicaid as the bedrock of public insurance and public assistance in America. Now, there’s evidence that it not only expanded health insurance coverage, but the electorate itself.
While disgruntlement among people with subsidized private plans on the exchanges over premiums and cost-sharing has provided much of the political ammunition for attempts to repeal Obamacare, Medicaid’s popularity and its guarantee of coverage formed much of the backbone of the opposition to Republican plans to repeal the law. But even before then, Medicaid played a role in the 2016 election, and may have helped reshape the electorate as we know it, increasing turnout among members of both parties.
That finding comes from new research by Jake Haselswerdt at the University of Missouri, which suggests that the ACA’s Medicaid expansion in 2014 increased political participation. The study, which will be published in the Journal of Health Politics, Policy and Law this month, “find[s] that the increases in Medicaid enrollment associated with the expansion are related to considerably higher voter turnout.” More specifically, the research indicates that for every increase in Medicaid enrollment in a district in 2014, there was a corresponding decrease in the “midterm dropoff” in turnout from 2012 to 2014.