Redistricting Watch: How Fair Maps Save Lives

Partisan and racial gerrymandering are insidious issues because they allow politicians to draw maps based on their own goals, rather than the interests of a given community. Politicians essentially pick their constituents, rather than the other way around. 

When district maps do not represent the people fairly, it prevents us from moving on issues that we care about – issues that can be a matter of life or death. One of these critical issues is healthcare.  

Redistricting and Healthcare 

So how does the drawing of district maps connect to healthcare?  

We just celebrated the 11th anniversary of the Affordable Care Act this month, and whether each state chooses to expand this healthcare law reveal a great deal about the impact of gerrymandering. 

Despite redistricting’s importance, many of us don’t quite understand what it entails. This makes sense, given that it only occurs every 10 years and the process can feel highly convoluted. 

Healthcare, on the other hand, is an issue that many of us are familiar with. As a campaign volunteer, I can testify to the hundreds of doors I knocked where voters told me their biggest concern was the state of healthcare. This urgency is understandable, given that accessibility and affordability pose major problems to the healthcare system, and that these problems were thrust into the spotlight during the COVID-19 pandemic.  

To understand how redistricting and healthcare impact one another, we can look to Medicaid. 

Medicaid is a federal and state program that offers subsidized health insurance for low-income Americans. The Affordable Care Act, which passed in 2010, included a provision to expand Medicaid eligibility, increasing its power to support people across the country. States that opted in would have up to 90% of the costs covered by the federal government.  

Since 2014, 37 states including DC have implemented the Medicaid expansion. The primary beneficiaries of this policy include low-income families and people who are pregnant, elderly, and/or disabled. A study from the National Bureau of Economic Research estimates that Medicaid expansion saved roughly 19,200 lives between 2014 and 2017. 

Unsurprisingly, Medicaid expansion received overwhelming public support. Yet in spite of this, 14 states opted out of expanding Medicaid, passing over the public opinion. Several of the 14 states were notably gerrymandered, suggesting that the decision did not reflect the will of the people so much as the political goals of their politicians. As a result of gerrymandering, hundreds of thousands of people were denied the benefits of the Medicaid expansion. Who can say how many lives have been impacted by that decision? 

Gerrymandering, Healthcare, and Racism 

In countless ways, healthcare is a racial justice issue. Implicit bias in the healthcare industry means that racial minorities are often discriminated against by medical professionals. COVID-19 has exacerbated longstanding inequities by disproportionately impacting communities of color, both in terms of economic welfare and health.   

This situation is made worse when their representatives refuse to pass life-saving legislation that would make Medicaid more accessible. This was the case for millions of Black Americans, who are heavily represented within the very states that opted out of Medicaid expansion. Currently, Black Americans are nearly twice as likely as whites to be uninsured; why would the very states that represent them fail to expand healthcare access? It inevitably suggests racial gerrymandering, when boundaries are drawn to explicitly disempower people of a specific race. 

Even when gerrymandering is not done to explicitly disempower Black and brown communities, it can have devastating effects on marginalized people. In addition to saving tens of thousands of lives, Medicaid expansion narrowed racial disparities in health coverage and access to care. In states where gerrymandering led politicians to opt out of Medicaid expansion, despite its overwhelming public support, Black and brown Americans were denied that step towards greater equity. 

Case Studies: Virginia and North Carolina 

I grew up in Virginia, a state that has been gerrymandered extensively. Across our districts, including those that are both heavily rural and conservative, Medicaid expansion gained significant support. In 2017, a historic election brought the Virginia House to a 51-49 split, with Republicans maintaining a slim majority, despite Democrats winning 53% of the popular vote. This small margin allowed Medicaid expansion to pass with bipartisan support.  

In states where legislators sit in comfortable majorities due to partisan gerrymandering, voters aren’t afforded this possibility. For example, let’s look to North Carolina. 

Several of North Carolina’s governors, both Democrat and Republican, and the majority of North Carolina voters support Medicaid’s expansion. Yet the state’s Republican leaders have remained staunchly opposed to expansion, which has prevented it from passing. Partisan gerrymandering has allowed these leaders to remain in power – in the 2020 statewide elections, Democrats won only 51 out of 120 House seats despite earning nearly half of the popular vote. Once again, thousands of people’s voices were ignored while politicians were able to push their own agendas. 

Partisan gerrymandering has no place in our democracy. Redistricting in 2021 offers Americans a prime opportunity to change these unfair dynamics.  

How Can You Get Involved? 

This year, all fifty states will receive the 2020 Census data and draw new maps for their federal, state, and local districts. During this process, we have the chance to right some of the wrongs from the last redistricting cycle and make our representation more accurate. Here is a list of ways that you can get involved in your state’s redistricting process: 

• Read more about your state’s process for redistricting this year – some states’ maps are drawn by independent or bipartisan commissions, while others are drawn by the majority party in the legislature. 
• Learn more about how racism and redistricting intersect. 
• Share your story with your redistricting commission/committee – many states have public input opportunities for voters and residents to provide testimony. 
• Write to your representatives about why fair maps are important to the issues you care about. 
• Talk to your friends and family about why these issues are important. The more people care about redistricting, the more pressure you can put on your government to draw fair maps. 
• Tell you Senator to support the For the People Act to establish fairer redistricting practices. 
• Find a League near you! 
• Follow LWVUS on OutreachCircle to stay up to date with action items and helpful resources about redistricting and other democracy reform.