Chiquita Brooks-LaSure in front of a microphone.

Chiquita Brooks-LaSure testifies before the Senate Finance Committee during her nomination hearing to be administrator of the Centers for Medicare & Medicaid Services in Washington on Thursday, April 15, 2021.

(Photo: Caroline Brehman/CQ-Roll Call, Inc via Getty Images)

Why Is Biden’s Medicaid Office Holding Out on Voter Registration?

Several states have attempted to implement automatic voter registration based on Medicare enrollment—but the Centers for Medicare and Medicaid Services is still stalling.

Recent efforts to expand access to automatic voter registration are again calling attention to old promises by the Biden administration to enhance the accessibility of civic engagement and continued failures by the Centers for Medicare and Medicaid Services to actualize them. Even this week, a piece in the magazine Bolts highlighted how a holdout by Biden officials continues to stall efforts to support low-income residents in registering to vote, despite recent Oregon legislation to automatically register Medicaid enrollees.

A 2021 Executive Order by President Joe Biden sought to promote access to voting, particularly by “expanding access to voter registration and election information,” in a directive to agencies to provide additional access to voter registration with services that directly engage with the public. Automatic voter registration through Medicaid enrollment offices is a common-sense way to expand opportunity for civic engagement among those most likely to be excluded by current voter registration infrastructure, and enables the National Voter Registration Act to move towards achieving its full potential.

Automatic voter registration (AVR) has proven effective in increasing voter registrations across a myriad of states—and not just by the number of voters registered, but in ensuring that the registered voter population is more diverse. And states like Oregon, Massachusetts, and Colorado have worked to take this even further, through AVR for Medicaid recipients.

The holdout by Brooks-LaSure, and CMS more broadly, stands in stark contrast with explicit steps set out by President Biden to improve accessibility to voter engagement.

And despite what the wishy-washy response from the Centers for Medicare and Medicaid Services (CMS) on the issue might indicate, AVR based on Medicaid enrollment has tremendous potential:

Despite the overwhelming positive evidence of improvements to voter registration infrastructure, CMS has taken no action to enable states that have passed legislation to actually use Medicaid for automatic voter registration. In a response to a letter from Sen. Michael Bennett (D-Colo.) in support of Colorado’s Medicaid efforts, CMS Administrator Chiquita Brooks-LaSure expressed aversion to the use of Medicaid for voter registration, citing conflict with Medicaid privacy concerns. CMS rules currently prevent Medicaid agencies from using enrollment data for non-Medicaid purposes, but CMS can waive these provisions to implement certain proposals at the state level. Even prior CMS officials have indicated support for state-based health insurance exchanges facilitating voter registration.

The holdout by Brooks-LaSure, and CMS more broadly, stands in stark contrast with explicit steps set out by President Biden to improve accessibility to voter engagement. And CMS has resisted fully stepping into its authority in a number of other Executive Orders and actions called for by President Biden—notably, but not limited to the Executive Order on Competition in its calls for coverage for generic drugs and biosimilars. The far-reaching authorities and impacts of CMS, and its role in healthcare for all Americans, deserve additional scrutiny and oversight from the Department of Health and Human Services.

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