Of equality- as if it harm’d me,
giving others the same chances
and rights as myself-
as if it were not indispensable
to my own rights
that others possess the same.”
― Walt Whitman, Leaves of Grass
As we have discussed in these monthly reports in the past, I am incredibly proud that the MHA is committed to the health equity journey, which once again has been identified by the MHA Board of Trustees as one of our association’s strategic pillars for this program year. We have made progress, with much more work on the docket.
It is clear that to achieve health equity, there are multiple complex factors that must be addressed, and by now most of us in the healthcare field recognize how issues like food insecurity, transportation and housing all play a significant role. But there is another important consideration: the ability to participate in elections is one of the foundational elements of our American democracy, and just as our member hospitals are very engaged in removing barriers to healthcare access, Secure Automatic Voter Registration (AVR) removes a barrier for low-income Michiganders in the voter registration process.
In our health equity journey, we have learned that we can’t take certain things for granted. A small but illustrative example: when my physician prescribes for me an important medication that must be refrigerated, neither one of us has traditionally thought twice about it….but what if the patient in question can’t afford their utilities bill, or can’t afford a refrigerator to begin with? In the same manner, most of us don’t think twice about registering to vote, either by driving to the Secretary of State office or logging on to our computer. But what if we don’t have a car and can’t afford a computer or internet access?
At the end of the day, the MHA is an advocacy organization, so we know all too well that elections at both the state and federal levels have major consequences on healthcare funding, and a wide range of public policies that affect health insurance, pharmaceutical access and so much more. It is only logical that the very people who are directly impacted by these healthcare funding and policy decisions should have a voice in the process.
House Bill 4983 currently introduced in the Michigan Legislature would help expand representation in Michigan by using existing government data to register eligible voters. Referred to as Secure Automatic Voter Registration, those receiving Medicaid benefits would be automatically registered to vote, increasing the number of eligible voters by approximately 400,000 to 600,000. Medicaid was picked for several specific reasons. First, the agency already verifies citizenship, which is a requirement for voter registration. Only limited non-health data would be securely and electronically shared with election officials, who would use this information to either register nonregistered Michiganders or update existing registration. New or updated voters would receive a mailer providing an opportunity to decline the registration or correct the information.
Second, registering Medicaid enrollees would address election inequities. People of color, new U.S. citizens, young adults, people with disabilities and low-income individuals are disproportionately excluded from voting in the U.S. and overrepresented among Medicaid enrollees. We know Medicaid beneficiaries, in aggregate, tend to have additional challenges that impede their ability to register to vote, such as working multiple jobs, transportation access, available childcare and other needs.
Lastly, Medicaid provides a secure avenue to update voter registration rolls, as Medicaid offices routinely work with public health information and have experience securely sharing data. The agency routinely shares data securely with other agencies to determine access to additional benefits and with outside organizations that provide healthcare and other services. Such a system streamlines the voter registration process because the state already has the required information on file needed to register to vote. It also allows information to be updated more regularly, improving the accuracy of the voter rolls.
The MHA supports efforts to increase voter participation and we believe that Medicaid Automatic Voter Registration helps to achieve that goal while improving the efficiency of voter registration. The country still only has 69.1% of the voting-age population registered to vote and we can do better. We also see communities with higher voter turnout have better health outcomes, in part due to increased attention and resources from elected officials. In our quest to address inequities across the board, Medicaid AVR is a step in the right direction of improving access to resources within Michigan’s minority and underrepresented populations.
As always, I welcome your thoughts.