Voting rights are health rights, so let’s reject the SAVE Act

By R. David Rebanal and Shayna Sta. Cruz., Special to CalMatters

This comment was originally posted by CalMatters. Sign up for their newsletters.

Guest Comment written by

As the US Senate debates the SAVE America Act, the national conversation is focusing on voting rights. But for communities of color in California — and for those of us who study what makes people sick and what keeps them healthy — this legislation represents something more insidious: a direct attack on public health.

As public health researchers at San Francisco State University, we recently hosted focus groups of Asian American Californians in the Bay Area and Fresno and Orange counties. We asked them about their neighborhoods, health and attitudes to civic life.

What we were told was sobering.

Again and again, participants described how their exclusion from political life—through language barriers, mistrust of government, and a lack of safe, centralized public spaces—translated directly into unmet health needs: clinics that didn’t speak their language, mental health services that didn’t exist, health policies that ignored them entirely.

One participant put it simply: when your community has no political voice, no one is fighting for your health.

This goes beyond anecdotes; it’s science. Political participation is socially established the determinant of health and racial justice. Politically engaged individuals report better health and lower rates of physical disability.

Studies of African-American communities in racially segregated neighborhoods found that where voter turnout was higher, birth outcomes are better. States with higher voter turnout iinvest more in health infrastructure and Medicaid. The ballot box, it turns out, is an intervention in public health.

Now consider what the SAVE Act would do for California.

According to a recent report from the University of Southern California, nearly 21% of Asian Americans who voted in 2020. did not return to the polls in 2024, the second highest dropout rate of any racial group.

And in the 2024 general election, only 54% of Asian Americans eligible to vote in California cast a ballot — 8 percentage points below the state average. Voter turnout among eligible Latinos is even lower, at just 46%.

These communities are already politically marginalized. The SAVE Act would enshrine this marginalization in law.

Approximately 146 million Americans lack of a valid passport. Only 21% of Americans earning less than $50,000 own one, compared to 64% of those earning more than $100,000.

Naturalized citizens — disproportionately immigrants of color who have gone through the judicial process that supporters of the SAVE Act claim to protect — often do not have easy access to birth certificates or naturalization papers.

Kansas enacted a similar requirement for proof of citizenship and blocked 31,000 eligible citizens from registering to voting, far more than any non-citizen ever identified.

Meanwhile, noncitizen voting is now illegal and extremely rare: A comprehensive review of Utah’s more than 2 million voter registrations found exactly one confirmed case.

Supporters of the SAVE Act claim it is election security, but it is history repeating itself.

Poll taxes, literacy tests, grandfather clauses — every generation of voter suppression has arrived dressed in the language of protectionism and common sense. The SAVE Act is no different. It narrows the electorate by making participation expensive, complicated and intimidating — especially for immigrant communities already wary of federal anti-immigration crackdowns.

When these communities are pushed further from the ballot box, the consequences reach every clinic, every school health program, every community health center whose survival depends on political champions.

Silencing voices doesn’t just change elections. It changes health outcomes.

California senators must vote against it. And the rest of us—researchers, clinicians, community members—must make it clear that the right to vote is a right to health care. The fight against the SAVE Act is not just about democracy. It’s about who can be healthy in America and who can’t.

This article was originally published on CalMatters and is republished under Creative Commons Attribution-NonCommercial-No Derivatives license.