A sign at a Newton polling place during the September 14, 2021, preliminary municipal election. (Photo by Shira Schoenberg)

EVERY YEAR, thousands of Massachusetts residents see a doctor—but never see a ballot. For low-income and minority communities that face barriers to voter registration, health care facilities can offer a solution: making civic engagement easier by reaching people where they are.

Registries of motor vehicles, or RMVs, are currently a main location for voter registration. The National Voter Registration Act, nicknamed the “Motor Voter Act,” requires RMVs to offer automatic voter registration, making the process seamless for new Massachusetts residents getting driver’s licenses or registering their cars. But low-income and immigrant individuals are less likely to drive and own a car, and therefore many may never visit the RMV. These communities have disproportionately low voter registration rates.

But where does nearly everyone visit? Hospitals, clinics, and community health centers. In 2023, 96 percent of Massachusetts residents reported visiting at least one health care provider in the past year. And the halls of our hospitals are filled with millions of visitors. These spaces are under-tapped resources that should offer voter registration to the vast, diverse people that they serve.

It’s also the law. Just as the National Voter Registration Act requires voter registration assistance at RMVs, it also requires it at state-run hospitals (and other offices) that offer public assistance. The reason? To ensure that those who may not visit the RMV—but may seek resources like health care through MassHealth and SNAP’s food benefits—are also afforded their right to access the ballot box.

But Massachusetts’s public hospitals, whose social work offices offer public assistance, are currently not complying with this federal law. And because public hospitals primarily serve minority and low-income individuals who are already less likely to be registered voters, this failure makes their disproportionate disenfranchisement even worse. Boston-based legal organization Lawyers for Civil Rights is putting pressure on the Commonwealth to come into compliance. With other election reforms like same-day voter registration gaining momentum, Massachusetts should satisfy its existing legal obligations under the National Voter Registration Act as well.

Private health care facilities can also give voting support in addition to medical support. Just as quality improvement measures have been successfully integrated across health care systems, voter registration services can be seamlessly incorporated into routine patient care. And bringing voter registration into health care facilities isn’t just a smart use of existing resources, but it also has snowballing benefits.

Health care systems have long recognized that addressing social determinants of health, including civic engagement, can dramatically improve patient outcomes. When patients have accessible pathways to register to vote while receiving care, we’re not just treating their immediate health needs, but empowering them to advocate for policies that affect their long-term well-being. This represents the kind of systematic, evidence-based approach to health care improvement that can benefit both individual patients and entire communities.

The registration deadline for this November’s election is fast approaching — on October 25. Massachusetts can register many more voters by that time — and that would especially be the case if public hospitals were to offer the required voter registration assistance and private health care facilities stepped up to join this effort.

Let’s meet people where they already are—doctors’ offices and emergency rooms—to improve patients’ health and the health of our democracy.

Brooke Simone is a staff attorney at Lawyers for Civil Rights in Boston. Donald Berwick is the former administrator of the Centers for Medicare and Medicaid Services and former president and CEO of the Institute for Healthcare Improvement.