January 9, 2024

59 Organizations Nationwide Urge U.S. Health Secretary, CMS to Issue Medicaid Automatic Voter Registration Guidance

Seven States and D.C. Await Implementation Guidance from the Centers for Medicare and Medicaid Services (CMS) and Biden Administration to Begin Enrolling Voters

For Immediate Release:

January 9, 2024



Chicago, IL — More than four dozen policy, grassroots, and community based organizations are urging U.S. Secretary of Health and Human Services (HHS) Xavier Becerra and Administrator of the Centers for Medicare and Medicaid Services (CMS) Chiquita Brooks-LaSure to release guidance that will ensure effective implementation of Secure Automatic Voter Registration (SAVR) at Medicaid offices. The organizations issued a letter calling on Sec. Becerra and Administrator Brooks-LaSure to prioritize working with Colorado, Oregon, New Mexico and other states that have passed legislation authorizing SAVR at Medicaid so they can begin automatically registering eligible U.S. citizens to vote when they apply for Medicaid services.

This development comes on the heels of letters from Governor Polis of Colorado, Governor Kotek of Oregon, and Governor Lujan Grisham of New Mexico to DHS and CMS requesting that the federal government work with their states to design and implement automatic voter registration systems that maximize voter registration for historically disenfranchised groups.

“At a time when we’ve seen bitter, partisan divisions around election integrity and voter access, SAVR at Medicaid will not only make our elections more secure and efficient, but bring more voices—historically underrepresented voices—into our democratic process,” said Sam Oliker-Friedland, executive director of the Institute for Responsive Government. “Seven states have been waiting patiently for implementation guidance to put this commonsense policy into action. They shouldn’t have to wait any longer.”

As of the end of 2023, seven states — Colorado, Massachusetts, Michigan, Minnesota, New Mexico, Nevada, and Oregon — and Washington D.C. all have passed laws instructing state Medicaid offices to automatically register eligible U.S. citizens to vote when they apply for Medicaid. With multiple states ready to implement SAVR at Medicaid, they now wait for clear direction from the CMS in order to ensure effective implementation of SAVR at Medicaid offices, with a system that maximizes both registrations and protections for Medicaid applicants.

“With SAVR at Medicaid offices, we have the ability to register millions of voters and eliminate the registration gap in states around the country,” Oliker-Friedland added. “CMS and the Biden Administration should act now for the good of millions of eligible American voters and the future of our country.”

Data shows that SAVR at Medicaid offices is uniquely situated to register millions of eligible Americans who are unreachable by any other identifiable means, such as people with disabilities, nursing home residents, and low-income working voters. The policy is expected to help states achieve near universal voter registration for eligible voters.

To read the full sign-on letter from 59 organizations around the country, click here. 

Additional Background:

Data from Nevada, Oregon and Colorado — states currently waiting to implement SAVR at Medicaid — show the potential of this policy.

SAVR at Medicaid (Post Transaction Opt-Out)

State Current Registration Total [1] Est. New Registrations from SAVR at Medicaid Est. Remaining Unregistered with SAVR at Medicaid
Colorado 3,916,868 513,323[2] 28,713
Nevada 1,953,489 307,731[3] 34,193
Oregon 3,408,727 171,000[4] 30,176

In Oregon, Secure AVR at Medicaid will reach 85% of the remaining eligible but unregistered population:

  • At least 25% of the 171,000 eligible but unregistered voters on Oregon Medicaid are people of color, roughly double the representation of people of color on the existing voter rolls.
  • 53% of the eligible but unregistered voters on the Oregon Health Plan are under the age of 35, which again represents a major increase compared to existing records, indicating that this reform will meaningfully improve overall representation on the voter rolls.

To speak with Sam Oliker-Friedland about SAVR at Medicaid and the urgency for CMS implementation guidance, please contact dan@responsivegoverningaction.org.


The Institute for Responsive Government is a nonpartisan nonprofit dedicated to ensuring state and federal governments work effectively for the very people they serve. The Institute for Responsive Government  provides data, research, and expertise to elected officials in order to find practical policy solutions that make government systems more efficient, accessible, and responsive.


[1] Information provided in Tables 1, 2, 3, and 4 for the current registration total and the unregistered population is sourced from data from TargetSmart.

[2] Information provided to the Institute for Responsive Government by Colorado’s Secretary of State

[3] Estimate from national voter file matches & TargetSmart data

[4] Oregon Secretary of State. Legislative Testimony. February 10, 2023. Link