Hundreds of thousands of poor people across the country are set to be covered for the first time under government-funded Medicaid after Tuesday’s election results.
Voters in Kansas, Maine, and Wisconsin flipped their governors from Republicans to Democrats who vowed to allow more people to receive Medicaid coverage under a provision created by Obamacare. Voters in Utah, Nebraska, and Idaho approved ballot measures to opt for expansion under Obamacare, which will allow people making less than $17,000 to receive coverage the government pays for.
In those states Medicaid was previously limited only to a smaller group of people, including residents with disabilities and pregnant women. The expansion means that income level becomes the only stipulation qualifying people for the program. As a result, as many as 651,000 more people are projected to be added to Medicaid rolls, according to an analysis by the consulting firm Avalere Health.
The Democratic candidates had vowed to expand Medicaid quickly. Kansas Gov.-elect Laura Kelly, a Democrat, promised to sign expansion during her first year in office, citing the closures of rural hospitals. The legislature is likely to follow her lead given that it had voted in 2017 to expand Medicaid. At the time, then-Gov. Sam Brownback, a Republican, vetoed the bill.
Tony Evers, who defeated Wisconsin Gov. Scott Walker, campaigned not only on the promise to expand Medicaid soon after being elected, but said that by the end of his first term he wants residents to be able to enroll in the program as a public option alternative to private healthcare coverage.
And in Maine, where voters had approved expansion through a ballot measure last year, the provision is likely to move forward quickly. The governor-elect, Janet Mills, has said she would allow the expansion to move forward after the current governor, Republican Paul LePage, has held it up for more than a year over a funding dispute.
The funding battle in Maine highlights potential snags for expansion in Idaho and Nebraska. Lawmakers will still need to come up with funding to pay the share of the expansion in those states. The federal government pays for the bulk of the expenses, and states shoulder 7 percent of total costs beginning in 2019. In Utah, the expansion was funded through a tax on all non-food items.
It wasn’t a win across the board for Medicaid expansion. Democratic candidates in Georgia and Florida who had promised to seek the provision did not win their respective governors races. In Montana, voters appear poised to reject a ballot measure that would make expansion permanent by funding it through a nicotine tax. The tobacco industry spent nearly $18 million encouraging Montanans to reject the tax, and as of Wednesday morning it appeared the measure was set for defeat.
Republicans have opposed Medicaid expansion, saying it is too costly and that the program should go toward the citizens it had focused on exclusively before Obamacare, including people with disabilities, pregnant women, children, and the elderly.
Democrats say that covering more low-income people will assist hospitals and help those who are struggling with medical conditions, helping them to receive treatment and in some cases enable them to return to work.
“This election proves that politicians who fought to repeal the Affordable Care Act got it wrong,” said Jonathan Schleifer, executive director of The Fairness Project, the group behind the ballot measures. “Americans want to live in a country where everyone can go to the doctor without going bankrupt. Expanding access to health care isn’t a blue state value or a red state value; it’s an American value.”
As Obamacare was originally written, all states were set to expand Medicaid to people making less than $17,000 a year beginning in 2014. People at that level of income are largely uninsured, and under the expansion, income is the only factor in qualifying for enrollment.
A Supreme Court decision made the expansion provision optional, and as a result the District of Columbia and 33 states have expanded while other states have not, excluding Tuesday’s ballot votes.
