Two guys from the tiny town of Sandpoint, Idaho, are trying to do what their political leaders won’t: Provide health coverage to tens of thousands of low-income Idahoans.
Through a political action committee they founded called Reclaim Idaho, Luke Mayville and Garrett Strizich, both 32, are traveling the state collecting signatures to put the question of whether to expand Medicaid under the Affordable Care Act before the voters.
“If I can, I want to make a difference where I grew up, because where I grew up has been overtaken by similar kinds of politics that seem to be taking over the country,” Mayville told HuffPost. “So I want to do something to push back against that.”
The Idaho effort is one of several in conservative-leaning states seeking to duplicate what activists in Maine achieved last November through a ballot initiative to expand Medicaid in that state.
Advocates in Nebraska and Utah also are working to gather signatures to put Medicaid expansion on the ballot, and a retiree in Missouri has taken up the cause for a long-shot bid to do so as well.
These campaigns to expand health coverage using funding the Affordable Care Act provides come at a time when President Donald Trump and the GOP-led Congress are busy rolling back other parts of the 2010 law and implementing changes to Medicaid policy that make it harder for low-income people to get and keep health benefits.
“Maine really motivated myself to look into the ballot route,” Nebraska state Sen. Adam Morfield said.
He and other Nebraska legislators have tried advancing Medicaid expansion through legislative channels for years, and are trying again this year.
But Morfield said he’s also working with private organizations to get the issue on the ballot this November. The Nebraska legislature consists of a single chamber and is technically nonpartisan, but Morfield, a Democrat, is effectively in the minority.
Expanding Medicaid could benefit 90,000 Nebraskans, Morfield said. They have to gather signatures representing 10 percent of the state’s registered voters ― about 120,000 people ― and submit them by July 6, according to Nebraska law.
The Affordable Care Act called for Medicaid to become available to anyone with an income below 133 percent of the federal poverty level, which is about $16,000 for a single person.
A 2012 Supreme Court ruling made this policy optional for states, however, and 18 states have declined to participate. Nationwide, almost 2.5 million people who would qualify for Medicaid under this policy are uninsured, according to the Henry J. Kaiser Family Foundation.
In Idaho, Mayville, Strizich and his wife, Emily Strizich, are traveling around the state in a camper van the Strizichs bought last year for $1,500, which they’ve decorated with the campaign’s name and dubbed the “Medicaid Mobile.”
Mayville and Garrett Strizich each grew up in Sandpoint, a town with fewer than 8,000 residents that sits about an hour south of the Canadian border and an hour or so east of Washington state. Sandpoint is known to some as the birthplace of 2008 Republican vice presidential nominee Sarah Palin.
The Strizichs live in Moscow, Idaho, where Garrett is in medical school and Emily is an occupational therapist who primarily works with low-income children with disabilities. Mayville currently resides in New York City, where he teaches political philosophy at Columbia University, and travels back to Idaho regularly.
They’ve raised about $10,000, along with contributions of gasoline and supplies for their barnstorming campaign, mostly from the residents of their hometown, Mayville said.
Idaho is a conservative state, but Mayville is optimistic the campaign can succeed at extending health coverage to as many as 78,000 Idahoans. “Our kind of philosophy all along has been that it’s actually a kind of Republican elite and activist class that is really against these programs, whereas the broader base of voters is not,” he said.
Reclaim Idaho has a tough task ahead just to give voters a chance to decide. They must collect signatures from 6 percent of the state’s registered voters, or about 56,000 people. They must also meet that percentage threshold in 18 of 35 state legislative districts. The deadline to submit signatures is May 1.
Mayville and the Strizichs, for now, are pretty much on their own, though they hope to gain the support of other organizations.
The Utah effort has been able to gather wider backing because advocates have been pushing for Medicaid expansion since the Supreme Court ruling almost six years ago, said RyLee Curtis, the campaign manager for Utah Decides Healthcare.
“Our coalition grew over the years. We got more businesses and chambers of commerce on board, and that drew the attention of our funders,” Curtis said.
One advantage the Utah ballot push has over Idaho’s is that Medicaid expansion has been the subject of a public debate in the state for several years already. Utah’s state Senate passed a privatized version of Medicaid expansion in 2016 with the support of Gov. Gary Herbert (R), but the bill died in the state House. Medicaid expansion could provide coverage to an estimated 120,000 Utahns.
“You’re seeing a frustration from Utah voters in that we want to see good policies go forward, and the Utah legislature is not reflecting or acting in a way that Utah voters want to see them act on these issues,” Curtis said. There hasn’t been a ballot initiative presented to Utah voters since the 1990s, but there could be as many as five this November, she said.
Utah Decides Healthcare has until April 15 to collect about 113,000 signatures, which represents 10 percent of the number of Utahns who voted in the 2016 presidential election. As in Idaho, the signatures must come from all over the state; in Utah, that means meeting the 10 percent threshold in 26 of 29 state Senate districts, Curtis said. “It’s going to be close, but it’s not so close that we’re nervous about it,” she said.
A key player in the Maine and Utah ballot campaigns will decide soon whether to join the fights in Idaho and Nebraska. The Fairness Project, a labor-backed organization that successfully promoted the Maine Medicaid initiative last year and minimum-wage-increase initiatives in five states in 2016, sees expanding health care as a priority, executive director Jonathan Schleifer said.
“There’s no better way to improve people’s lives,” Schleifer said.
The Fairness Project serves as a support system for these statewide ballot initiatives, conducting public opinion research, helping with signature-gathering, providing data modeling and other means of assistance. But the group is choosy about where to devote its resources and only wants to support campaigns that will actually result in the change they’re seeking.
“We’re not interested in principled wins or principled losses. We want to see the impact,” Schleifer said.
“We’ve had early conservations in Idaho and Nebraska. We are optimistic that we’re going to be able to advance Medicaid on the ballot in both of those states and we think that if we do, we will be able to expand Medicaid,” Schleifer said. The Missouri effort is too much of a long shot, he said, and he doesn’t expect to see ballot campaigns in any other states this year.
“As we look at the current landscape and current political environment, progressive groups are all rightfully playing defense, holding the line fighting for immigrants, fighting for LGBTQ rights,” Schleifer said. “We see a unique opportunity to go on offense.”