Shortly after the passage of the Patient Protection and Affordable Care Act, Democrats engaged in a furious debate about the long-term political ramifications of the law. Although virtually all Democrats agreed that the law represented a step forward in policy terms—expanding health insurance coverage to millions of people while outlawing discrimination over pre-existing conditions—they disagreed about its political impact.
“Americans were crying out for an end to the recession, for better wages and more jobs; not for changes in their healthcare,” New York Democratic Sen. Chuck Schumer, today the Senate majority leader, argued in 2014. In his view, if Democrats had focused more on battling the immediate effects of the Great Recession, they would’ve seen better electoral outcomes in the years since.
But new research suggests that making Americans healthier could, in the long run, increase civic participation by boosting voting rates.
Turnout and health status
In a paper recently published in the Journal of Health Politics, Policy, and Law, Georgetown University political scientist Gregory Lyon used election data from the 2012 and 2016 elections gathered in the Cooperative Congressional Election Study (CCES) and the American National Election Studies (ANES) to analyze voter turnout as it compared to postelection data explaining respondents’ reasons for nonvoting. Lyon sought to understand the relationship between health status and voting.
What he found was that a “high-income individual in poor health is no more or less likely to vote than a high-income individual in good or even excellent health,” but that things were very different from low-income people. Among low-income people, an individual with poor health was about seven points less likely to turn out to vote than a poor person who has excellent health. Meanwhile, “a low-income individual in poor health is 10 points more likely to cite sickness as an electoral impediment than an otherwise similar high-income individual who is also in poor health.”
“There are a number of other factors that affect turnout, but the results suggest that improving low-income individuals’ health status would likely have a positive effect on low-income individuals’ likelihood of turning out to vote. To the extent that greater citizen engagement is a sign of a healthy democracy, then the findings suggest that policy that improves low-income individuals’ general health status may also serve to improve the health of democratic institutions,” Lyon told BlueTent in an email.
A vicious or virtuous cycle?
While health insurance coverage is just one factor of many that contributes to a healthier populace, Lyon notes that in the 2012 CCES, around 29% of low-income respondents said they had no health insurance while around 4% of high-income respondents said the same thing. He concludes that the “results here point to a pernicious cyclical process in which low-income individuals in poor health are least likely to turn out to vote, least likely to receive political representation, and therefore, least able to counter retrenchment efforts that further compound health-related problems.”
However, it should be noted that this vicious cycle could be turned into a more virtuous cycle. If Democrats continue to prioritize expanding access to healthcare—as well as supporting other efforts to improve Americans’ health status, like reducing pollution, promoting access to healthier food and encouraging exercise—they could very well increase voter turnout among groups of people who lean Democratic.
