Obamacare May Be More Political Than You Think

The health care law could help millions of people register to vote.

Anti-Obamacare protesters wear masks of U.S. President Barack Obama and Grim Reaper as they demonstrate in front of the U.S. Supreme Court June 28, 2012 in Washington, D.C.
National Journal
Sophie Novack
Oct. 14, 2013, 4:52 p.m.

As mem­bers of Con­gress con­tin­ue to ar­gue over the Af­ford­able Care Act, one im­pact of the law on par­tis­an polit­ics has largely been left out of the con­ver­sa­tion: voter re­gis­tra­tion.

The Na­tion­al Voter Re­gis­tra­tion Act of 1993, also known as the “Mo­tor Voter” law, re­quires gov­ern­ment agen­cies to of­fer in­di­vidu­als the op­por­tun­ity to vote — and that in­cludes the newly opened Obama­care ex­changes.

That gives some Re­pub­lic­ans one more reas­on to op­pose the law. If low-in­come ap­plic­ants lean Demo­crat­ic, the ar­gu­ment goes, the ex­changes could boost the party’s voter rolls.

“The prac­tice raises long­stand­ing sus­pi­cions on the right that the ACA ex­changes are de­signed for polit­ic­al as well as reg­u­lat­ory pur­poses,” said Tim Miller, a seni­or fel­low at the Amer­ic­an En­ter­prise In­sti­tute.

Con­ser­vat­ive talk show host Rush Limbaugh has been char­ac­ter­ist­ic­ally blunt on the sub­ject. “The pur­pose of Obama­care got noth­ing to do with your health, and noth­ing to do with your in­sur­ance,” he said. “It’s about build­ing a per­man­ent, un­defeat­able, al­ways-fun­ded Demo­crat ma­jor­ity.”

In Wash­ing­ton, Rep. Charles Bous­tany, R-La., sent a let­ter to Health and Hu­man Ser­vices Sec­ret­ary Kath­leen Se­beli­us in March, ex­press­ing con­cerns about the link­ing of ACA in­sur­ance ap­plic­a­tions to voter re­gis­tra­tion.

“While the health care law re­quires that gov­ern­ment agen­cies col­lect vast in­form­a­tion about Amer­ic­ans’ per­son­al lives, it does not give your De­part­ment an in­terest in wheth­er in­di­vidu­al Amer­ic­ans choose to vote,” he wrote.

Bous­tany’s of­fice did not re­spond to re­quests for com­ment.

Yet voter-rights ad­voc­ates main­tain that voter re­gis­tra­tion is not a par­tis­an is­sue. “Those new voters could be up for grabs by all parties,” said Laura Murphy, dir­ect­or of the Amer­ic­an Civil Liber­ties Uni­on’s Wash­ing­ton le­gis­lat­ive of­fice. “I think it’s very un­reas­on­able to as­sume someone vot­ing for the first time is ne­ces­sar­ily go­ing to be vot­ing one way or the oth­er.”

Ac­cord­ing to the Cen­ters for Medi­care and Medi­caid Ser­vices, voter re­gis­tra­tion must be offered on the ACA ex­change ap­plic­a­tion be­cause of the Medi­caid eli­gib­il­ity de­term­in­a­tion. To be in com­pli­ance, CMS says they are in­clud­ing lan­guage on the pa­per and on­line ap­plic­a­tions that says, “If you want to re­gister to vote, you can com­plete a voter re­gis­tra­tion form at usa.gov.” States that have op­ted to cre­ate their own ex­changes are able to de­vel­op their own ap­plic­a­tions and choose how they en­force the Na­tion­al Voter Re­gis­tra­tion Act re­quire­ment.

Cali­for­nia was the first state to de­cide to en­force voter re­gis­tra­tion re­quire­ments through the ACA. “Nearly 5.8 mil­lion Cali­for­ni­ans who are oth­er­wise eli­gible to vote are not cur­rently re­gistered,” said Demo­crat­ic state Sen. Alex Pa­dilla, who au­thored the bill en­for­cing voter re­gis­tra­tion. “Covered Cali­for­nia [the state’s ex­change] provides a unique op­por­tun­ity to re­duce the num­ber of un­re­gistered Cali­for­ni­ans and in­crease par­ti­cip­a­tion.”

Five oth­er states have also pub­licly an­nounced their in­ten­tion to en­force the Na­tion­al Voter Re­gis­tra­tion Act: Con­necti­c­ut, Mary­land, New York, Rhode Is­land, and Ver­mont, ac­cord­ing to Eu­nice Rho, ad­vocacy and policy coun­sel for ACLU. The six states are solidly blue, but Rho says that di­vide began with the broad­er de­cision of wheth­er to es­tab­lish a state-based ex­change. States that op­ted to cre­ate their own tend to lean Demo­crat­ic.

However, Rho main­tains that the voter-re­gis­tra­tion ele­ment is a non­par­tis­an is­sue. “We should all agree that voters should be giv­en the op­por­tun­ity to par­ti­cip­ate in the polit­ic­al pro­cess,” she said. “Why not get at voters when they’re ac­cess­ing the sys­tem in large num­bers?”

Suc­cess­fully im­ple­ment­ing voter-re­gis­tra­tion re­quire­ments in­to the ACA ex­changes could give up to 68 mil­lion ad­di­tion­al eli­gible voters the chance to re­gister, ac­cord­ing to Demos, a left-lean­ing policy or­gan­iz­a­tion.

Over­all, more than 250 mil­lion people have re­gistered to vote through the Na­tion­al Voter Re­gis­tra­tion Act between 1995, when the law went in­to ef­fect, and 2010, Demos re­ports. To put that in per­spect­ive, an es­tim­ated 126 mil­lion people voted in the 2012 elec­tion, ac­cord­ing to the Bi­par­tis­an Policy Cen­ter.

“It’s a really sig­ni­fic­ant op­por­tun­ity to ex­pand vot­ing re­gis­tra­tion,” Rho said, not­ing that about one-third of un­in­sured in­di­vidu­als are not re­gistered to vote.

Said Murphy: “One thing we all should be in fa­vor of — wheth­er Demo­crat, Re­pub­lic­an or in­de­pend­ent — is we should make vot­ing more ac­cess­ible, not less.”

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