Nebraska is the latest state looking to put Medicaid expansion on the ballot next year after Maine’s successful referendum earlier this week.
Led by Republicans, Nebraska’s legislature has rejected Medicaid expansion five times. But a Democratic state lawmaker thinks a question put before Nebraska voters in the 2018 general election next November would have a better chance.
Nebraska State Sen. Adam Morfeld began pushing a Medicaid expansion ballot initiative this week with the idea that “legislators will be more open to a vote of the people” since the Affordable Care Act has become such a divisive political issue among lawmakers.
“When it comes to healthcare, Nebraskans are going to be much more reasonable to policy options to make it more affordable,” Morfeld said in an interview. “The Affordable Care Act is such a politically toxic issue in Nebraska that it’s essentially shut down debate on how we make healthcare more affordable.”
Nebraska would join Utah and Idaho in considering initiatives to decide Medicaid expansion at the ballot box . Groups pushing expansion in these states see Maine’s referendum as a model. In Maine, voters approved Medicaid expansion after Republican Gov. Paul LePage five times vetoed legislation to expand insurance to the state’s poor.
Maine and the other 18 holdout states have already missed 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. Beginning this year, states gradually began to pick up some costs, but 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.
Already, about 11 million Americans have gained coverage from Medicaid expansion in 31 states and the District of Columbia under the ACA. If the other remaining 18 states join Maine to expand Medicaid, another 2.5 million Americans would gain health coverage. Continued expansion among holdout states would be a boost to insurance companies in the Medicaid business such as Anthem, Aetna, Centene, Molina Healthcare and UnitedHealth Group.
Aside from Maine’s successful ballot initiative, Tuesday’s election brought the election of a Democratic governor in Virginia where the Republican House of Delegates has balked at Medicaid expansion.
But Democrats Tuesday picked up at least 14 Virginia House seats and potentially more as votes continue to be counted. And that threatens the GOP’s 32-seat House majority in the 100-seat Virginia legislative chamber.
“Previous efforts by the incumbent governor to expand Medicaid ran into opposition in the House of Delegates,” Fitch Ratings said in a report Wednesday, the day after general elections. “ A switch in control of the House could make Medicaid expansion much more likely in Virginia as the commonwealth’s senate, which had no seats up for election (Tuesday), previously indicated support for expansion.”