Medicaid Expansion Boosts Voter Registration: New Evidence from State-Level Data

Insights from the Field

Medicaid expansion

National Federation of Independent Business v. Sebelius

voter registration

Patient Protection and Affordable Care Act

The Politics of Policy: The Initial Mass Political Effects of Medicaid Expansion in the States was authored by Joshua Clinton and Michael Sances. It was published by Cambridge in APSR in 2018.

### Policy Impact

This study examines how the politically contentious Patient Protection and Affordable Care Act (ACA) of 2010 influenced voter registration following implementation. By analyzing cross-state differences created by a key Supreme Court ruling, researchers found that counties in states expanding Medicaid saw significantly higher voter registration rates than similar non-expansion counties.

### Research Design

It compares changes between expansion and non-expansion states using state-level data from January 2014 to December 2016. The analysis focuses on counties with the largest percentage of eligible beneficiaries, revealing concentration effects not present elsewhere.

### Key Findings

Increases in voter registration were evident as early as 2014 and persisted through at least 2016
No statistically significant impact was found on overall voter turnout during this period
Political engagement changes appear tied specifically to counties with high beneficiary populations

### Real-World Significance

This research demonstrates that even in politically charged environments, social policy expansions can measurably increase political participation. Results suggest potential for ACA implementation to influence electoral dynamics beyond its intended healthcare outcomes.