In June 2012, the Supreme Court upheld the core of the Affordable Care Act but said that each state could decide whether or not to implement a core provision, the expansion of Medicaid to cover low-income people just above the poverty line. That judicial development triggered partisan battles over Medicaid expansion. More than two dozen states have agreed to take federal funds to enroll more people in Medicaid, but twenty-three states led by Republicans are so far refusing. As the battles rage on, the people we almost never hear from are those currently enrolled in Medicaid. Why? The easy answer is that many of those who utilize Medicaid are poor, and impoverished Americans participate less readily than others in elections and other arenas of democracy. But in addition to low levels of income and educational attainment, could there be something about Medicaid itself that discourages many beneficiaries from active political participation? My research looks into this question, asking how poor people’s experience of receiving Medicaid influences their political outlooks and participation in democratic citizenship. The findings are in many ways troubling – and they underscore the impact of varied experiences with Medicaid and associated social and institutional realities in different U.S. states….