Healthcare comprises almost 20% of the United States gross national product. In our effort to keep our readers informed about the topics that most impact on their lives we presented a writing last week by Dr. Robert Pearl entitled, “In healthcare’s game of Monopoly, one player will control the board,” in which Dr. Robert Pearl presented a private solutions to inefficiencies and problems that exist in America’s health care industry. Today we present a video from IssueOne examining the healthcare industry. Right now, healthcare lobbyists are legally allowed to buy our elected officials’ votes. As long as that’s the case, our representatives will continue to choose campaign donations over Americans’ lives. The healthcare industry spends more than anyone else lobbying politicians to rig the system on their behalf. That should be illegal, but it’s not.
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Introducing The Expand Democracy 5
If you want to suggest a pro-democracy idea for coverage in The Expand Democracy 5, please use the contact form at Expand Democracy.
Turnout in Off-Cycle Elections: News from Florida, Wisconsin, and West Virginia
Recent nationally prominent elections in Florida and Wisconsin, along with legislative developments in West Virginia, offer valuable insights into strategies that can enhance voter turnout during off-cycle elections.
Florida's Special Elections: In April 2025, Florida conducted special elections for two congressional seats. Despite the Republican Party retaining both seats, Democratic candidates Gay Valimont and Josh Weil significantly narrowed the margins by collectively raising over $16 million, compared to the Republicans' combined $3.1 million. This financial advantage enabled Democrats to mount robust campaigns, contributing to unexpectedly competitive races in traditionally Republican strongholds. Voter turnout was relatively high - indeed higher in one race than any of the 12 special elections for the House in 2022-2024, as reported in an important CNN story on”off-cycle” turnout.
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Wisconsin Supreme Court Election: On April 1, 2025, Wisconsin held a Supreme Court election that garnered national attention. Liberal candidate Susan Crawford defeated conservative Brad Schimel, maintaining the court's 4–3 liberal majority. The election saw unprecedented spending, totaling nearly $100 million, making it the most expensive judicial race in U.S. history. Voter turnout was exceptionally high for a spring election, with nearly 70% of the participation level seen in the November presidential election. This surge in turnout, particularly in Democratic strongholds like Milwaukee, where some polling stations ran out of ballots, highlights the impact of voter mobilization efforts and the electorate's responsiveness to high-stakes judicial contests.
It is important to clarify that Wisconsin did not hold a special election; instead, it was off-cycle. High turnout in such an election can be misleading, as more normal is the low voter turnout this month in mayoral elections in Oakland and St. Louis. What might be effective strategies to increase turnout in elections not held in November of even-numbered years?
West Virginia's Election Consolidation Effort: In a move to enhance turnout and reduce costs, the West Virginia Senate unanimously approved legislation: requiring municipalities to hold their elections concurrently with statewide elections by 2032. Proponents argue that this alignment will increase voter awareness and turnout, as citizens are more likely to participate when multiple significant races are on the ballot. However, some local officials express concerns that municipal issues may be overshadowed by state-level contests, potentially diminishing the focus on local governance.
Sightline Institute has been a leading advocate for aligning local elections with state and federal contests - a reform known as election consolidation. Their research underscores that this shift can significantly boost voter turnout, often doubling participation rates in local elections. For instance, in Washington state, Sightline found that even-year elections attracted 62% more voters compared to odd-year elections, translating to an additional 1.2 million ballots cast statewide. In the context of West Virginia's recent legislative move to require municipalities to hold elections on the same day as statewide elections by 2032, Sightline's findings suggest that such consolidation could enhance democratic engagement and ensure that local governance more accurately represents the electorate's will.
These developments underscore the importance of election timing and structure in influencing voter engagement. As states and municipalities consider reforms to boost participation, the experiences of Florida, Wisconsin, and West Virginia offer valuable insights into the challenges and opportunities of fostering a more inclusive democratic process.
Resources:
- The Bipartisan Policy Center examines the potential impact of election consolidation in South Carolina on turnout and demands on election officials.
- As reported in last week’s Expand Democracy 5, voting by mail can lead to higher turnout in off-cycle elections.
Surging Use of Ranked Choice Voting on Campus - and What It Says About the Future of Democracy 🎬
Ranked choice voting (RCV) continues its steady march across American campuses, with over 100 colleges and universities now using RCV to elect student leaders - representing nearly every state in the country. Elections just this week included wins by Andrew Boanoh at Yale, Ethan Lynne at George Washington, Jack Steffen at Emory’s Oxford College, and Abigail Verino at UC-Berkeley (with nearly 10,000 votes cast) and current elections at New Jersey Institute for Technology.
This surge isn't just a procedural change, it reflects a generational demand for more voice and more choice. Research consistently shows that young Americans are both more open to electoral reforms like ranked choice voting (RCV) and open primaries and more likely to support systems that reward collaboration over conflict. On campuses, students are embracing RCV as a way to avoid “vote splitting” and ensure winners have broad support - values that mirror growing national support for reforms like RCV in local and state elections.
Diagnosing Gerrymandering: Binghamton Researchers Propose Value-Based Approach to Fair Elections
In a recent study, Binghamton University political scientists Daniel Magleby and Michael McDonald liken gerrymandered electoral maps to a form of illness, suggesting that understanding the specific "symptoms" of a distorted map requires identifying the democratic values it violates.
Their study, published in the Election Law Journal, evaluates five analytical methods across 37 states' congressional maps post-2020 Census, revealing consistent partisan gerrymandering in four states, no evidence in 12, and mixed results in the remaining 21. The authors argue that effective diagnostics must be grounded in clear principles, specifically: ensuring minority voices are heard and that majority rule is upheld. They caution that redistricting commissions, while often seen as solutions, can still produce gerrymanders if not guided by these core values.
This research underscores the importance of value-driven frameworks in creating fair electoral maps, emphasizing that without clear standards, efforts to combat gerrymandering may fall short.
Resources:
- Groups playing important roles in raising awareness about redistricting reform and seeking reform include Common Cause, the League of Women Voters, and the Campaign Legal Center.
- FairVote and its allies lift up The Fair Representation Act as a sweeping remedy
States Drive Electoral College Reform💡
For many Americans, the current rules of the Electoral College represent the biggest eyesore in American democracy: candidates focus all their energy on seven swing states, presidential governance favors those states, and candidates can lose even after securing a majority of votes. Over the past two decades, 18 states (counting DC) have passed the National Popular Vote plan that, once adopted by states representing a majority of Electoral College votes, would guarantee the White House to the candidate who wins the most popular votes in all 50 states and DC. Maine is the most recent state to adopt it, with public opinion and good policy on their side. States with legislation seeking to adopt the National Popular Vote plan this year include Arizona, Florida, Pennsylvania, South Carolina and Texas.
Maine and Nebraska are the only two states that don’t always award all of their electoral votes to one candidate, as they allocate some votes based on congressional district results. Nebraska’s governor has aggressively sought to repeal the district system in the wake of Democrats starting to win in the Omaha area, but his effort once again failed in Nebraska’s unicameral legislature. One factor may be that a Maine legislator introduced a bill designed to have Maine also move to statewide winner-take-all if Nebraska were to act -- with results in recent years conveniently providing partisan balance because Donald Trump has been winning Maine’s northern congressional district electoral vote even while losing the state.
In the long run, it is critical to discuss tactics for securing a national popular vote in tandem with a fully safeguarded right to vote and majority rule via a runoff or instant runoff system. Keep an eye out for more updates from Expand Democracy.
Resources:
- Advocates of National Popular Vote in Maine include League of Women Voters of Maine, with support from National Popular Vote and national groups like Represent.Us providing testimony this year in its defense.
- Rob Richie, in 2015, coauthored the Fuzzy Math report critiquing the congressional district allocation system as a national reform approach. He also is a coauthor ofEvery Vote Equal (2024 edition).
Timely Links
We will close The Expand Democracy 5 with notable links, including followups to recent topics.
- College Park expands voting rights: Following last week’s 5, the home of the University of Maryland has become the 9th Maryland city to expand voting rights in city elections to otherwise eligible voters who are 16 and 17.
- Only one in seven Americans casting meaningful votes: The Unite America Institute this week released important new research on the dominance of small primary electorates in our winner-take-all elections: Just 14% of eligible American voters cast a meaningful vote to elect the entire U.S. House and 13% of voters cast a meaningful vote to elect members of their state house of representatives.
- Trump’s Assault on Constitutional Norms: In the wake of last week’s 5, there is no shortage of relevant news about the Trump administration’s challenge to our constitutional norms Adam Serwer in the Atlantic suggests Trump’s defiance of the Supreme Court involving deportation without due process represents a constitutional crisis, as also addressed by Ruth Marcus in the New Yorker. Trump is also challenging academic freedom through freezing long-term federal research grants and threatening the nonprofit tax status of Harvard University.
- Our Politics Really Can Work – These Stories Show How: FairVote’s Meredith Sumpter and Sightline’s Alan Durning write for The Fulcrum on the impact so far on governance of forms of ranked choice voting in Alaska and cities.
- Rolling Stone overview on federal and state challenges to voter access: Rolling Stone provides a comprehensive review of executive orders and legislation that threaten to weaken voting rights.
- Unlock Democracy has its 10 Year Anniversary: Rob was one of the sources for Michael Golden for his book making the case for structural electoral reforms, including the Fair Representation Act in Congress.
