It’s the right’s worst nightmare: Obamacare working to boost not just the number of Americans who have affordable health insurance—but also the number who are registered to vote. And it could be coming true.
Take it from Rush Limbaugh.
“What do you really think is going on?” the conservative radio host asked his listeners while discussing the Affordable Care Act (ACA) last October. “Voter registration. In addition to you going to get your health care, there is obviously massive Democrat voter registration going on at these exchanges.”
Limbaugh isn’t entirely wrong.
Under the terms of an agreement announced this week between California and an alliance of good government groups, the state will mail voter registration forms to 4 million people who applied for Obamacare via California's online exchange. The deal could end up creating 400,000 new registered Golden State voters—the actual numbers will be available later this year.
Nationwide, Obamacare could ultimately be responsible for registering anywhere from 3 to 7 million voters—potentially over 10% of the total number of eligible voters who aren’t registered today—over the next eight years.
“We think it’s a huge opportunity to reach people,” Sarah Brannon of Project Vote, which worked on the California settlement, said of the health care law.
Here’s why: Under the 1993 National Voter Registration Act (NVRA), which aimed to boost voter registration, people applying for public assistance—as well as DMV customers—must be offered the chance to register to vote. That means every state insurance exchange like California’s, as well as the federal exchange, will need to ask people whether they want to register. Even those people who end up getting covered via Obamacare’s Medicaid expansion or through other parts of the law, rather than through the private market, will still be offered the chance to register to vote.
The numbers are necessarily ballpark figures—but they’re impressive nonetheless.
Demos, a progressive group that works with Project Vote on the issue, has used Congressional Budget Office numbers to estimate that by 2022, a total of 68 million Americans will have gotten health insurance thanks to the ACA's various components.
Using results from past efforts to track the rate of response to voter registration solicitations, Demos also estimates that between 5 and 10% of those people will register to vote. That means when all is said and done, anywhere from 3.4 to 6.8 million people might end up registering.
But Lisa Danetz, a senior counsel with Demos, said those estimates were conservative, in part because they don’t include people who apply for health coverage but don’t end up signing up for it, perhaps because they’re deemed ineligible. So the final number could be even higher.
Still, much depends on the details of implementation. After congressional Republicans raised concerns about the ACA being used for voter registration, the Obama administration soft-pedaled the requirement on the federal exchange by merely including a one-sentence link to an all-purpose federal government website. Project Vote and Demos have said that approach isn’t enough to comply with the NVRA, and are urging the administration to make it more prominent. Many state exchanges also still aren’t complying with the law, the groups say.
But the California deal could act as a spur to beef up compliance, said Danetz.
“The settlement agreement really provides a template for what all of the exchanges should be doing,” she said, calling it “a very concrete example for other states and the federal exchange to look at.”
In some ways, Obamacare represents the perfect voter registration tool, because there’s a high degree of overlap between the group of Americans that aren’t registered to vote and those that are uninsured and eligible for health coverage under the law: In a nutshell, both groups skew poor and non-white.
The Medicaid expansion—which already has allowed an estimated 4.6 million Americans to get health coverage—is particularly effective, Brannon said. Almost everyone who’ll be eligible for it is not already on another form of public assistance, meaning they likely wouldn’t have been exposed to other chances to register to vote through contact with the government.
Indeed, many on the right see the ACA as an elaborate plot to boost voter registration among Democratic constituencies. Some say registering voters through the law opens the door to non-citizen voting—though in reality, the safeguards are no different than they are for those registering to vote through other methods.
"This entire scheme is an outrage beyond anything I've ever experienced before," Gregg Phillips, a conservative activist who supports voting restrictions, told msnbc. "The very idea that they would have used a stalking horse like healthcare to register, in their own words 68 million Americans to vote – or 68 million new voters, not necessarily Americans – is a problem."
"The only way to do that is to pick up all the illegals," Phillips added.