Speaking of Medicaid expansion, reports came in this week out of Idaho that a campaign to put the question on the ballot before voters is just 1,200 valid signatures away. They’ve already cleared the more difficult hurdle, Boise State Public Radio reports:

It’s taken months, but Medicaid for Idaho organizer Sam Sandmire says the group has met one of two requirements to get the group’s initiative on the ballot in November.

They gathered enough signatures across different legislative districts, but they still need about another 1,200 valid signatures from anywhere in the state.

“Gathering six percent of registered voters’ signatures in 18 different districts in a rural, spread out state like Idaho is an extraordinary task,” Sandmire says.

The group hopes voters will get a chance to decide whether or not to extend Medicaid coverage to up to 62,000 Idahoans who currently earn too much to qualify for the program, but earn too little to get a subsidy for a health insurance plan offered under the Affordable Care Act. 

Meanwhile, campaigners behind a ballot initiative for Medicaid expansion in Utah recently got enough signatures to put the question on the ballot this November, and a similar campaign has just begun collecting signatures in Nebraska, Huffington Post reports. It’s a clever maneuver by enterprising citizens to get around Republican legislators too frightened of Obamacare politics and advocacy groups like Americans for Prosperity to accept billions of dollars in federal money to provide health insurance for their states’ poorest citizens.

The same approach was taken in Maine, which approved Medicaid expansion via a popular ballot initiative last year. However, Gov. Paul LePage, one of the most unpopular governors in the nation, is attempting to use procedural maneuvers to block its implementation in a sad, doomed, bitter attempt to overrule the will of the people and deny health insurance to poor people in the final year of his term.

Currently, thirty-two states have expanded Medicaid since the option first became available in 2014, along with the District of Columbia. Virginia may well be on the cusp of joining them.

For all of the sound and fury from the refusnik states back in the debates of 2013, we’re seeing a pattern that is somewhat similar, if a bit slower, to the original Medicaid program. When Medicaid was enacted as a federal-state partnership in 1965, some states dragged their feet. When the funds first became available, half of states participated. That was up to 37 two years in. By the time the program had been running for four years, nearly all states had signed up. Alaksa held out until 1972 and Arizona until 1982.

As for Medicaid expansion, as I’ve noted in this space before, the latecomers have missed out on three years of 100 percent federal funding. States that waited left billions of dollars on the table for no reason, trying to cut off Obama’s nose to spite the face of their own citizens. Sad! In Arkansas, the pragmatists won the day, and the state benefited from billions of dollars to provide coverage to its poorest citizens.

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Citizens in western states aim to expand Medicaid via ballot iniative