![]() ![]() The final section of the report provides a policy solution: voter-determined districts. The subsequent section highlights four states where data show that gerrymandering likely played a key role in restrictions on Medicaid eligibility: North Carolina, Wisconsin, Michigan, and Georgia. The first section explains two common state efforts to limit access to health care: 1) refusing to expand the state Medicaid program to provide low-income adults access under the ACA and 2) initiatives to take coverage away from beneficiaries who do not meet burdensome work requirements. This report analyzes the relationship between gerrymandering and Medicaid policy. A 2019 report from the Center for American Progress demonstrated how gerrymandering has stopped state legislatures from taking action to prevent gun violence, blocking the passage of popular, commonsense measures such as universal background checks and extreme risk protection orders. Gerrymandering affects everything that legislatures do by shifting who gets elected in the first place. Evidence shows, however, that Medicaid work requirements not only result in low-income people losing health coverage but also fail at their purported objective of boosting employment. In Michigan-another state with heavily gerrymandered districts-conservatives in control of the Legislature have attempted to limit beneficiaries’ access to Medicaid through the imposition of burdensome work requirements. ![]() In North Carolina, Wisconsin, and Georgia-three states that have not expanded Medicaid-1 million more people would have been insured and roughly 3,000 deaths would have been prevented in 2019 alone if the expansion had been fully implemented. And that means that on issues such as the expansion of Medicaid, conservative politicians can cater to the extreme right wing and oppose policies that would save lives at minimal cost to state taxpayers. 3 By gerrymandering their districts, politicians can stay in power-and keep their political parties in power-even if they lose voter support. Many of these states have failed to expand Medicaid because of partisan gerrymandering-the practice of drawing district lines to unfairly favor particular politicians or political parties. While Medicaid enjoys strong public support, officials in a handful of states are refusing to act in the interests of their own citizens. ![]()
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