In our highly-focused, micro-targeted, ultra-specific campaign environment of 2020, everyone is looking for that critical swing voter. Those mysterious voters who may tip the scales in favor of Vice President Joe Biden or Donald Trump.
Are they gay white Republican millennials who hate fracking so they flip for Joe Biden? Are they suburban African-American Muslim moms who hate babies in cages but are convinced by Lil Wayne that Trump’s Platinum plan will put a milli a milli a milli in their pockets?
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Better yet, maybe they’re anti-vax COVID-19 truthers who believe that only a Biden-Harris administration will put Pizzagate pedophiles in jail? If the current polling just days before the 2020 election is any indicator, the key swing voters of 2020 are nothing sexy, idiosyncratic or unknown.
They are Medicaid Expansion voters, and they just might be what puts Joe Biden over the edge in the 2020 election.
What a difference a decade can make. Just 10 years ago, the Affordable Care Act was a millstone around the neck of Democrats. While many voters liked the individual parts of the bill, protection against insurance upcharges for pre-existing conditions, keeping children on family healthcare plans until the age of 25, expansion of Medicaid to millions, Obamacare itself, remained extremely unpopular especially with certain segments of white people.
Study after study showed that racial resentment by whites drove opposition to Medicaid expansion, all the while poor whites and those with substandard employee health benefits gained the most under the policy. Medicaid expansion remained mostly unpopular right up until newly elected President Donald Trump tried to get rid of it. John McCain historically saved the bulk of Obamacare, millions realized just how close they were to losing what little benefits they had, and a new slice of voters was born.
Read More: Trump blocks states from using Medicaid to respond to coronavirus crisis
Just how important have Medicaid Expansion voters become electorally? Voters fearing the loss of medical coverage are widely credited with the Democrats winning the House of Representatives in the 2018 mid-terms. However, when you dig into the weeds, these voters maybe even more important in 2020. Medicaid fills in the gaps for millions of working Americans, who may have healthcare from their jobs but need additional coverage.
Over 60 percent of Americans with Medicaid coverage are working, and most for small businesses with less than 50 employees. These are your office managers at a small tow truck company in central Ohio. These are your custodians at the office park outside of Gainesville, Florida. The payroll services contractor working just outside of Flagstaff, Arizona. These people are Black, Brown, men and women, but mostly white.
Those who aren’t working who are covered under Medicaid expansion are usually suffering from chronic illnesses or disabilities. It’s the Medicaid Expansion voter that explains Biden’s strong showing with white seniors and how he remains competitive with non-college-educated whites — a group of voters that Trump carried by double digits against Hillary Clinton throughout the 2016 election.
Read More: Trump decides not to reopen Obamacare enrollment amid coronavirus
So what do these swing voters look like in real life numbers? Numbers that could potentially give us a new president by Nov. 4? The Association for Community Affiliated Plans (ACAP) put out a Medicaid Voter profile that should have plenty of GOP senators and representatives shaking in their boots.
If Medicaid Expansion voters were a single state, they would have a larger population and more electoral votes than California. If you look at Medicaid Expansion voters within a few key swing states, their population is larger than the margin of victory in the 2016 presidential election.
| State | Electoral Votes | Margin of Victory | Medicaid Expansion Pop. |
| Mich. | 16 | 11,612 | 684,103 |
| N.H. | 4 | 2,732 | 55,024 |
| Minn. | 10 | 43,785 | 197,968 |
| Nev. | 6 | 26,434 | 213,869 |
| Maine | 4 | 20,035 | 57,665 |
| Ariz. | 11 | 84,904 | 414,465 |
| Colo. | 8 | 71,741 | 411,490 |
Many of these voters who pulled the lever for Trump in 2016 have soured on him at some level since that fateful day. The Republicans’ inability to come up with a replacement plan for Obamacare, and obsession with appointing judges that will try to destroy the policy through court rulings, have put Senate races into play for this demographic as well.
In roughly six states with highly competitive Senate races, Medicaid Expansion swing voters are larger than the margin of victory in that state’s last Senate election. Which explains why Republicans like Martha McSally (R-AZ) are running ads claiming she’s supporting the very policy she votes against, and Joni Ernst (R-IA) is getting hammered for voting against Obamacare four times.
| Senator | State | Victory Margin | Medicaid Expansion Pop. |
| Sullivan | Alaska | 6,014 | 45,29 |
| McSally | Ariz. | 328,022 | 414,465 |
| Gardner | Colo. | 39,688 | 414,465 |
| Ernst | Iowa | 94,205 | 167,984 |
| McConnell | Ky. | 222,089 | 454,781 |
| Collins | Maine | 223,251 | 57,665 |
| Daines | Mont. | 65,525 | 96,177 |
| Jones | Ala. | 21,924 | n/a |
| Tillis | N.C. | 45,608 | n/a |
| Graham | S.C. | 192,009 | n/a |
Are Medicaid Expansion voters single-issue voters? Probably not, but neither are Palestinian American business owners in the Southwest who flipped from Obama to Trump. However, unlike voters in the demographic hodgepodge that the mainstream press is obsessed with, Medicaid Expansion voters have a very clear tangible loss if Donald Trump remains president and the Republicans keep the Senate.
They will lose their healthcare coverage. Not in theory, not hypothetically, and not in a gradual way. They know either through legislation or court ruling, Donald Trump will put them and millions of Americans off of the only consistent healthcare coverage they’ve ever known.
They may not like Joe Biden’s tax plans, may think Black Lives Matter is a little too loud, and think Twitter beefs with foreign leaders is tolerable but at the end of the day, only one candidate is going to keep their Medicaid Expansion whole — and that’s Joe Biden. Which just might be enough for them to send him to 1600 Pennsylvania avenue as the top-billed candidate.
Dr. Jason Johnson is a professor of Politics and Journalism at Morgan State University, a Political Contributor at MSNBC and SIRIUS XM Satellite Radio. Notorious comic book and sports guy with dual Wakandan and Zamundan citizenship.
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