California health exchange slow to offer voter registration

12/26/2013 12:00 AM

12/26/2013 6:39 AM

Supporters of the new national health care law portray California’s exchange as among the most successful at signing up residents for medical coverage.

But advocates of expanded access to the ballot box believe Covered California is failing miserably at carrying out another responsibility: Helping people register to vote.

The National Voter Registration Act requires public assistance agencies and designated departments to offer voter registration services, and federal and state officials have determined health insurance exchanges fit the criteria. Known as “motor voter” because of its required presence at the Department of Motor Vehicles, the 20-year-old law compels agencies to distribute voter registration cards to applicants, assist them in filing out the documents, and send completed cards to election officials.

“They haven’t done any of that,” said Lori Shellenberger, director of the American Civil Liberties Union of California Voting Rights Project. “Quite honestly, it’s baffling to me.”

Anne Gonzales, a spokeswoman for Covered California, countered that the exchange is working diligently to meet its obligations under federal and state voter registration laws. It recently appointed a staff member to work as a liaison with advocacy groups, established a voter registration Web page, and included tabs in multiple places in its enrollment pages, she said. Paper applications will be a component of the future efforts.

“This will be a long-term process, and we are making progress,” Gonzales said.

Having launched in October, the state exchange is approaching the halfway point of its first open-enrollment period. This week, Executive Director Peter V. Lee estimated that more than 400,000 residents have enrolled in coverage, excluding MediCal.

“I think a lot of the frustration comes from the fact that there’s a great need, that this is a great opportunity and there is this perception that we are missing that opportunity,” said Mindy Romero, director of the California Civic Engagement Project of the UC Davis Center for Regional Change.

In the original debate over the motor voter law, supporters said it was needed to broaden the electorate, particularly among under-represented groups. The idea was to to provide an immediate contact: education and applications to electoral subgroups that historically have had poor access.

In the latest showdown, the Obama administration through the Centers for Medicare and Medicaid Services said health insurance marketplaces were public service agencies because applicants could be eligible for services through an exchange or Medicaid. Not every state has come to agree, Romero said.

“Some are doing it and some are questioning it,” she said.

Even those states that have pledged to follow the president’s orders have differed in how, and when, they go about applying the mandate. What makes California stand out, Romero said, is Secretary of State Debra Bowen’s insistence in a May 15 letter that the state become “a national leader” in making certain those who apply for health benefits are given the opportunity to register to vote. Bowen’s designation was the first in the country.

“Covered California said things wouldn’t be perfect right off the bat,” Romero said. “But they aren’t doing things that they promised to do.”

California’s voter registration rate hovers near the bottom among the 50 states. According to U.S. census figures from late 2012, 54.2 percent of Californians of voting age were registered to vote. Only Hawaii ranked lower – barely – with 54.1 percent. California’s meager showing is due in part to delays in modernizing its voter registration database and poor implementation of the motor voter law, as confirmed in state audits, said Kim Alexander, president of the California Voter Foundation. When Bowen made her declaration, California was viewed as a key place where in one swoop, a large number of residents could join the electorate.

At more than 5 million, the number of eligible unregistered voters is roughly equal to the amount of people without health insurance. They tend to be younger, poorer, less educated and more ethnically diverse than their voting, insured counterparts, Alexander said.

As the exchange works to bolster outreach, she said it wasn’t enough for officials to simply link to the voter registration form.

“They need to provide the offer of assistance and then provide it,” she said, adding the advocates remain in talks with the exchange.

“I am glad that the lines of communication are open and that they are talking with us,” Alexander said. “What they have done so far tends to be the steps that are easier to do and don’t get them closer to complying with (the law).”

To address the lost opportunity, some have suggested mailing out registration cards. Yet they acknowledge the “cold” mailings would not have the same impact.

At a recent meeting of the exchange, Dr. Robert K. Ross, a board member, said with all of the agency’s focus on enrollment, voter registration could sometimes feel like an afterthought. Ross, president and chief executive for the California Endowment, a private foundation that works to expand access to health care in underserved communities, sought to assure advocates that fulfilling its obligation to boost voter outreach was a top priority for the exchange.

“It continues to be a very critical part of what we are doing,” he said.

Even as the exchange works to come into compliance, some elected officials say they don’t see it as the state’s job to get involved. Assemblyman Dan Logue, R-Marysville, questioned what health insurance policies have to do with residents registering to vote.

“Are they going to threaten to cut off their health care if they don’t register to vote?,” asked Logue, vice chair of the Assembly Health Committee and a member of the Assembly Committee on Elections and Redistricting. “Is that the next step by an overreaching government that thinks they should tell us how to blow our nose and when we should do it?”

Logue, who is challenging Democratic U.S. Rep. John Garamendi next year, said public confidence in the law and the exchanges was eroding.

“Nobody trusts what the big government says. Nobody believes them anymore,” he said. “There’s always an agenda that goes beyond health care. The real fear is: What is that agenda?”

Daniel Zingale, a senior vice president at the California Endowment leading its Healthy California team, said that given the controversy swirling around the health care law, it’s only right that the people most affected should be given a say in its future.

“We have confidence that the more people experiencing Obamacare and voting, the better the future is for the law,” he said.

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