Medicaid Made Me a Democrat: Effect of Medicaid Expansion on Partisan Identity

• In Event: Health Policy Feedback

Abstract

Transformational social policies have the ability to alter the political landscape. We examine the impact of Medicaid expansion under the Affordable Care Act, which provided health insurance to millions of low-income Americans. Previous studies have found muted effects of Medicaid expansion on the political system, but all have assumed stable party identification. We propose that Medicaid expansion may have actually changed Americans' political loyalties. Using difference-in-differences models on nationally representative surveys over 17 years, we show that Medicaid expansion produced a 2.8 percentage-point increase in the proportion of Americans who identify as Democrats. We do not find evidence that the effects were limited to respondents who were eligible for Medicaid, but the effects were divided along racial lines. Our findings suggest that transformational social policies may prompt Americans to reconsider even fundamental aspects of their political identities.

Authors

• Nolan M Kavanagh, Harvard University

• James Jolin

• Andrea Louise Campbell, Massachusetts Institute of Technology