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The Politics of Policy: The Initial Mass Political Effects of Medicaid Expansion in the States

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  • CLINTON, JOSHUA D.
  • SANCES, MICHAEL W.

Abstract

Whether public policy affects electoral politics is an enduring question with an elusive answer. We identify the impact of the highly contested Patient Protection and Affordable Care Act (ACA) of 2010 by exploiting cross-state variation created by the 2012 Supreme Court decision in National Federation of Independent Business v. Sebelius. We compare changes in registration and turnout following the expansion of Medicaid in January of 2014 to show that counties in expansion states experience higher political participation compared to similar counties in nonexpansion states. Importantly, the increases we identify are concentrated in counties with the largest percentage of eligible beneficiaries. The effect on voter registration persists through the 2016 election, but an impact on voter turnout is only evident in 2014. Despite the partisan politics surrounding the ACA–a political environment that differs markedly from social programs producing policy feedbacks in the past—our evidence is broadly consistent with claims that social policy programs can produce some political impacts, at least in the short-term.

Suggested Citation

  • Clinton, Joshua D. & Sances, Michael W., 2018. "The Politics of Policy: The Initial Mass Political Effects of Medicaid Expansion in the States," American Political Science Review, Cambridge University Press, vol. 112(1), pages 167-185, February.
  • Handle: RePEc:cup:apsrev:v:112:y:2018:i:01:p:167-185_00
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    Cited by:

    1. Juan Pablo Atal & José Ignacio Cuesta & Felipe González & Cristóbal Otero, 2024. "The Economics of the Public Option: Evidence from Local Pharmaceutical Markets," American Economic Review, American Economic Association, vol. 114(3), pages 615-644, March.
    2. Jeffrey Clemens & Michael R. Strain, 2020. "Public Policy and Participation in Political Interest Groups: An Analysis of Minimum Wages, Labor Unions, and Effective Advocacy," NBER Working Papers 27902, National Bureau of Economic Research, Inc.
    3. Charles Crabtree & John B. Holbein & J. Quin Monson, 2022. "Patient traits shape health-care stakeholders’ choices on how to best allocate life-saving care," Nature Human Behaviour, Nature, vol. 6(2), pages 244-257, February.
    4. Ganslmeier, Michael, 2023. "Are Campaign Promises Effective?," EconStor Preprints 274069, ZBW - Leibniz Information Centre for Economics.
    5. Eric Chyn & Kareem Haggag, 2023. "Moved to Vote: The Long-Run Effects of Neighborhoods on Political Participation," The Review of Economics and Statistics, MIT Press, vol. 105(6), pages 1596-1605, November.
    6. Salomo Hirvonen & Jerome Schafer & Janne Tukiainen, 2022. "Policy Feedback and Civic Engagement: Evidence from the Finnish Basic Income Experiment," Discussion Papers 155, Aboa Centre for Economics.
    7. Emilio Depetris-Chauvin & Felipe González, 2023. "The Political Consequences of Vaccines: Quasi-experimental Evidence from Eligibility Rules," Documentos de Trabajo 572, Instituto de Economia. Pontificia Universidad Católica de Chile..
    8. repec:aei:rpaper:1008580847 is not listed on IDEAS
    9. Alex Hollingsworth & Aparna Soni & Aaron E Carroll & John Cawley & Kosali Simon, 2019. "Gains in health insurance coverage explain variation in Democratic vote share in the 2008-2016 presidential elections," PLOS ONE, Public Library of Science, vol. 14(4), pages 1-16, April.
    10. Stommes, Drew & Aronow, P. M. & Sävje, Fredrik, 2023. "On the Reliability of Published Findings Using the Regression Discontinuity Design in Political Science," I4R Discussion Paper Series 22, The Institute for Replication (I4R).
    11. , 2023. "The Political Consequences of Vaccines: Quasi-experimental Evidence from Eligibility Rules," Working Papers 953, Queen Mary University of London, School of Economics and Finance.

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