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The Impact of Medicaid Expansion on Voter Participation: Evidence from the Oregon Health Insurance Experiment


  • Katherine Baicker
  • Amy Finkelstein


In 2008, a group of uninsured low-income adults in Oregon was selected by lottery for the chance to apply for Medicaid. Using this randomized design and state administrative data on voter behavior, we analyze how a Medicaid expansion affected voter turnout and registration. We find that Medicaid increased voter turnout in the November 2008 Presidential election by about 7 percent overall, with the effects concentrated in men (18 percent increase) and in residents of democratic counties (10 percent increase); there is suggestive evidence that the increase in voting reflected new voter registrations, rather than increased turnout among pre-existing registrants. There is no evidence of an increase in voter turnout in subsequent elections, up to and including the November 2010 midterm election.

Suggested Citation

  • Katherine Baicker & Amy Finkelstein, 2018. "The Impact of Medicaid Expansion on Voter Participation: Evidence from the Oregon Health Insurance Experiment," NBER Working Papers 25244, National Bureau of Economic Research, Inc.
  • Handle: RePEc:nbr:nberwo:25244
    Note: AG EH PE POL

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    Cited by:

    1. Gabriel Fuentes Cordoba, 2021. "Growing up in a civil war and political participation: Evidence from Guatemala," Economics of Transition and Institutional Change, John Wiley & Sons, vol. 29(2), pages 197-225, April.
    2. 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.
    3. Zou, Wei & Cheng, Bo, 2023. "Can rural health insurance coverage improve educational attainment? Evidence from new cooperative medical scheme in China," International Review of Economics & Finance, Elsevier, vol. 85(C), pages 689-704.
    4. Stephen B. Billings & Eric Chyn & Kareem Haggag, 2021. "The Long-Run Effects of School Racial Diversity on Political Identity," American Economic Review: Insights, American Economic Association, vol. 3(3), pages 267-284, September.
    5. Hugo Bodory & Federica Mascolo & Michael Lechner, 2024. "Enabling Decision-Making with the Modified Causal Forest: Policy Trees for Treatment Assignment," Papers 2406.02241,
    6. 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.
    7. Xinzheng Shi & Ming‐ang Zhang, 2020. "How does historical trauma affect political participation? Evidence from the send‐down movement in China," Economics of Transition and Institutional Change, John Wiley & Sons, vol. 28(1), pages 3-43, January.
    8. Alexander James & Nathaly M. Rivera & Brock Smith, 2022. "Cash Transfer and Voter Turnout," Working Papers wp536, University of Chile, Department of Economics.

    More about this item

    JEL classification:

    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private
    • I28 - Health, Education, and Welfare - - Education - - - Government Policy

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