Three Deep Red States Vote to Expand Medicaid

WASHINGTON — Voters in Idaho, Nebraska in addition to also Utah on Tuesday were on track to approve what their Republican-led legislatures repeatedly might not: free or low-cost health coverage for most poor adults through an expansion of their Medicaid programs. The three deep-red states are today poised to join 33 others in which have already expanded Medicaid, an option under the Affordable Care Act since 2014.

In Montana, where the legislature expanded the program in 2015, however only for four years, voters appeared to reject a plan to sharply raise the cigarette tax to pay the state share of the cost. Expanded Medicaid will today end there, unless the legislature agrees on another funding source. The tobacco industry poured more than $17 million into ads opposing the tax hike.

The success of the citizen-driven initiatives from the three some other states reaffirms the outsized role of Medicaid in expanding access to health care from the Obamacare era. In all, enrollment from the program has grown by at least 15.6 million, or 28 percent, since 2013, the year before the health law’s main provisions took effect. If lawmakers in Utah, Idaho in addition to also Nebraska don’t interfere — as happened in Maine, where Gov. Paul LePage has blocked an expansion of Medicaid ever since voters approved the item last year — an estimated 325,000 people from the three states will be able to enroll in Medicaid starting next spring.

In Maine, where Mr. LePage is usually leaving office because of term limits, the Democratic candidate, Janet Mills, won. She wants to immediately move forward with expanding Medicaid to at least 70,000 low-income adults there.

Prospects for expanding Medicaid also enhanced in Kansas, where Laura Kelly, a Democrat who supports doing so, won the governor’s race Tuesday, in addition to also Wisconsin, where Tony Evers, the Democrat, defeated Gov. Scott Walker. The Republican-controlled state legislature in Kansas voted last year to expand the program, however former Gov. Sam Brownback vetoed the bill.

In Georgia, Stacey Abrams, the Democratic candidate for governor who made expanding Medicaid a top priority, trailed her Republican opponent however was hoping for a runoff. The governor’s race in another state having a large uninsured population, Florida, went to the Republican candidate, Russ DeSantis, generating expansion unlikely there any time soon.

Opinion polls found broad support for Medicaid expansion from the three states where voters approved the item Tuesday — as well as nationally suggesting its popularity today cuts across party lines. In all three states, governors in addition to also candidates for governor had said they will accept whatever outcome the voters decide.

The biggest reason Republican lawmakers have opposed Medicaid expansion is usually concern in which the item will eat up too much of the state budget. In several states in which have already expanded the program, enrollment has far exceeded expectations, driving up costs. however under the terms of the health law, the federal government pays at least 0 percent of the costs for the newly eligible adult population.

In Nebraska in addition to also Idaho, the ballot initiatives did not include a way to pay the state share of expansion costs. in which could potentially make them vulnerable to the type of stalling in which’s happened in Maine, where Mr. LePage has grounded his resistance from the fact in which the initiative did not include a funding mechanism.

In Utah, the measure increases the state sales tax rate on items some other than food to 4.85 percent, through the current 4.7 percent, to pay the state share.

The largest donor overall to the Medicaid ballot initiatives was the Fairness Project, an advocacy group backed primarily by a California labor union. The group spent more than $5 million on signature-gathering efforts, advertising, field offices in addition to also some other efforts.

“This kind of election proves in which politicians who fought to repeal the Affordable Care Act got the item wrong,” said Jonathan Schleifer, executive director of The Fairness Project. “Expanding access to health care isn’t a blue state value or a red state value; the item’s an American value.”