TYou likely had the opportunity to register to vote at the same time as the last time you renewed your driver’s license. As former administrators of the Centers for Medicare and Medicaid Services at the Department of Health and Human Services, we believe Americans should have the same selective enrollment opportunity when they apply for health insurance at HealthCare.gov, the federal government’s online health portal. Insurance market place. While no legislative changes are required to make this a reality, HHS must make technical improvements to the HealthCare.gov platform and workflow. These changes create new opportunities for voter registration in 33 states Based on the federal marketplace for health insurance. The result: approx 1.2 million Every year, people register to vote or update their enrollment information through HealthCare.gov, according to Demos, the provider.
HHS has endorsed the goal of giving people a seamless opportunity to choose when applying for health coverage at the same time, consistent with President Biden’s March 2021 mandate. Executive order He called on federal agencies to “expand opportunities for citizens to register to vote.” While HHS is fully aware of the plan, we urge the Department to implement this simplification in time for the next open enrollment period this fall. This is reasonable for at least three reasons.
First of all, we believe that if the government wants to serve the people well, it has an obligation to facilitate citizen participation. And still, today, less than that Three out of four Eligible adults registered to vote and less than half They voted in the recent federal election. The government must do everything it can to make every American have a voice and make it count.
Second, as former administrators of Medicare and Medicaid, we understand the relationship between access and participation. One clear goal of the Affordable Care Act is to make it as easy as possible to apply for health coverage, including on HealthCare.gov. We have seen that the more opportunities there are when it comes to health insurance and the simpler and easier the application process is, the more eligible people can actually enroll. The same principle is true for voter registration. Continued growth is needed in both areas.
Third, civic participation in general, and voting in particular, are important influences on health and well-being. Research later Researchincluding Health and Democracy IndexShow that expanded voice and political representation can help people advocate for policies that support their well-being. in fact, Healthy People 2030 – HHS’s 10-Year Roadmap for Improving Health in the United States – describes increasing voter turnout as a key strategy for individuals to “help build healthier communities.”
Integrating voter registration into HealthCare.gov is common sense. HHS itself proposed this amendment More than a year ago” as stated in the new report titledStrengthening Democracy: A Progress Report on Federal Agency Action to Increase Electoral Access” was written by a coalition of more than 50 civil rights, health, immigration and other progressive organizations.
That progress report examines how 10 different agencies, including HHS, have implemented President Biden’s executive order. Although HHS has made a “strong initial commitment to integrate voter registration into HealthCare.gov,” the report says the administration “has not yet followed through on this promise” and recommends that HHS “immediately take steps to ensure voter registration.” HealthCare.gov is “fully operational through the open enrollment period beginning in late 2023.
Although we recognize that HHS will be handling many requests for the HealthCare.gov platform, we join the report’s authors in urging HHS to prioritize this work as Americans begin applying for health insurance before the election. Date 2024
This important update aligns HealthCare.gov with the work done by state Medicaid offices and state-based health insurance exchanges. The National Voter Registration Act, passed 30 years ago, directed government agencies that provide public benefits, including Medicaid, to help vote each time a person applies for benefits, renews benefits or changes address.
Voter registration is similarly integrated into the broader health insurance marketplace in 18 states (including Washington, DC). Because state exchanges accept applications for Medicaid and other benefits, they are required by the National Voter Registration Act to facilitate voter registration. Indeed, many states have developed and expanded online voter registration, including streamlined or automated registration processes at their exchanges, DMVs, and other platforms, which have significantly increased the cost of registration.
This same opportunity, however, is not available in the 33 states that rely on the federal HealthCare.gov platform, even though HealthCare.gov is intended to fulfill similar functions as a state-based exchange. In other words, HealthCare.gov does not fully meet its job description. This is a missed opportunity.
With updates to HealthCare.gov, HHS can strongly help strengthen our democracy this year and beyond. HHS has expressed support for incorporating voter registration into HealthCare.gov. To echo President Biden’s refrain from the State of the Union, it’s time to “get the job done.”
Andy Slavitt served as President Biden’s senior adviser on the Covid-19 response and from 2015 to 2017 as President Obama’s head of Medicare and Medicaid services, including the administration of the Centers for Medicare and Medicaid Services, including reform, implementation and advocacy of the Affordable Care Act. and HealthCare.gov. He is the host of the Inside the Bubble with Andy Slavitt podcast. Donald Berwick, MD, MPP, FRCP, a pediatrician by training, is president emeritus and senior fellow at the Institute for Healthcare Improvement, a nonprofit organization he co-founded and led for 19 years. He served as CMS Administrator from July 2010 to December 2011. He is a lecturer in the Department of Health Care Policy at Harvard Medical School. Cindy Mann, JD is a partner at Manat, Phelps & Phillips and works with clients to develop and implement strategies around federal and state health reform, Medicaid, the Children’s Health Insurance Program, and delivery and payment system change. From 2009 to 2014, she served as CMS Deputy Administrator and Chief of Medicaid and CHIP.