Medicaid expansion in Idaho, Nebraska and Utah is getting favorable polls and court victories as campaigns to win voter approval of ballot initiatives build momentum ahead of November’s midterm elections.
In two months, Nebraska, Utah and Idaho could follow the lead of voters in Maine who last November voted to expand Medicaid under the Affordable Care Act via ballot initiative. These states are seeking ballot initiatives because their Republican-leaning legislatures or governors have been roadblocks to the idea.
Supporters in Nebraska are cheering a judge’s ruling dismissing a partisan Republican effort to keep its initiative off the ballot, clearing the way for voters to decide whether to increase coverage more than 90,000 Nebraskans. The ballot initiative has been drawing bipartisan support from across Nebraska.
“The best indicators of support come from the number of signatures that we turned in,” Insure The Good Life campaign manager Meg Mandy said. “By statute, we had to have 7% of the total registered voters in the state (around 85,000), including 5% from 38 of Nebraska’s 93 counties. We turned in 135,000 signatures from voters in every county.”
Elsewhere, polls in Republican-leaning states show consistent momentum for Medicaid expansion building in what is expected to be a good year generally for Democrats given the unpopularity of Donald Trump and Democratic-leaning issues like Medicaid expansion.
In Idaho, 45% plan to vote “yes” on Medicaid expansion initiative compared to just 19 percent planning to vote “no.” Another 36% are unsure, the August poll of more than 800 likely voters by Campaign Clarity Labs shows.
The Campaign Clarity poll comes after a 2017 Idaho Public Policy Survey that indicated 70% of Idahoans favored “closing the health care coverage gap.” “These kinds of things can poll well in conservative states and I wasn’t surprised by the more recent numbers,” Boise State University political science professor Jeffrey Lyons said of the August Campaign Clarity poll.
Meanwhile, polls in Utah have shown Medicaid expansion has strong support with 63% in favor , according to a survey released in June by Dan Jones & Associates of more than 600 likely Utah voters showed. Just 30% oppose Utah Medicaid expansion while 7% don’t know, the Dan Jones survey shows.
The expansion of Medicaid benefits under the ACA has come a long way since the U.S. Supreme Court in 2012 gave states a choice in the matter. There were initially only about 20 states that sided with then President Barack Obama’s effort to expand the health insurance program for poor Americans.
But there are now 33 states plus the District of with 17 holdout states remaining that have been missing out on generous federal funding of the Medicaid expansion. From 2014 through 2016, the ACA’s Medicaid expansion population was funded 100% with federal dollars. Since last year, the federal government still picks up 90% or more of Medicaid expansion through 2020. It’s a better deal than before the ACA, when Medicaid programs were funded via a much less generous split between state and federal tax dollars.
A fourth Republican-leaning state, Montana, will decide in November whether to make its Medicaid expansion permanent once the state’s current expansion sunsets next year.
If any or all of the ballot measures pass, it could be a potential windfall to health insurance companies as well. Aetna, Anthem, Centene, Molina Healthcare and UnitedHealth Group have done well helping an increasing number of states manage their Medicaid benefits of poor Americans and the ACA’s expansion population has been a boon to these insurers.
“What we found when circulating the petition was that the cost of healthcare is an issue that doesn’t just affect Democrats or Republicans or Nebraskans that live in the metro areas or farm communities,” Insure the Good Life’s Mandy said. “It’s an issue that’s impacting people’s friends, families, and neighbors in all parts of the state, which is how we were able to get so many signatures in just a few months.”