Medicaid expansion was a key subject in this year's midterm elections. Three states - Idaho, Nebraska, and Utah - successfully passed ballot initiatives to expand their Medicaid programs, while Kansas and Maine elected pro-expansion governors. Because of this, almost 500,000 additional low-income citizens will be permitted to enroll in the government-run health program. Here is a recap of the latest expansion activity.
MEDICAID EXPANSION BALLOT INITIATIVES
IDAHO
Since voters in Idaho favored Idaho Proposition 2, Governor-elect Brad Little (R) will implement the initiative. The state is now obligated to submit an amendment plan to CMS that will carry out the expansion within 90 days of the approval. Additionally, the Idaho Department of Health and Welfare is authorized to take any actions needed to put the regulations into effect.
NEBRASKA
In spite of Governor Pete Rickett's (R) resistance to Medicaid expansion, Nebraska Initiative 427 successfully passed. The state will be required to submit a state plan amendment or documents for waiver approval on or before April 1, 2019 to CMS. Furthermore, the Department of Human Services is responsible for taking "all actions necessary to maximize federal financial participation in funding medical assistance pursuant to this section."
UTAH
Utah Proposition 3 was voted in favor of and it calls for Utah to expand Medicaid by way of the ACA starting April 1, 2019. The effort also restricts future changes to the program or CHIP that could possibly reduce coverage, benefits, or payment rates below policies from January 1, 2017. In order to fund the program expansion, the proposition will also increase the state's sales tax by 0.15%.
PRO EXPANSION GOVERNORS
While Kansas and Maine did not expand their programs with ballot initiatives, they are going after it with support from newly elected pro-expansion governors.
KANSAS
In 2017, the Kansas legislature passed a bill that would have extended Medicaid. However, the governor at that time, Sam Brownback (R), vetoed it. Presently, with Governor-elect Laura Kelly (D) assuming office, Medicaid expansion could very well materialize. Kelly has been a supporter of expansion and even ran on it.
MAINE
In 2017, Maine also passed a ballot initiative to expand Medicaid but the then governor, Paul LePage (R) refused to carry out the regulations. In fact, LePage even claimed that he would go to jail before putting the ballot initiative into action. Regardless of his resistance, voters elected Janet Mills (D) on Tuesday. The governor-elect ran on Medicaid expansion and is committed to implementing the 2017 initiative immediately after she takes office.
Medicaid expansion has bipartisan appeal. Based upon the Midterm results, voters appreciate better access to care and improved outcomes for low-income Americans.
Health economists have been monitoring the program's development and are optimistic about the impact expansion will have. Benjamin Sommers analyzes Medicaid expansion at Harvard and states, "In terms of what happens to patients, we have 40-plus studies looking at this over the past decade. It makes a major difference in patients' ability to access health care, to pay their bills, and in many studies, we see improved health outcomes too."
According to research, populations in states that expand the program have improved access to a larger range of health services. Individuals also declare that by having coverage, they incur less debt and are more capable of paying their health care bills. Other research found that states who expand Medicaid see a larger decline in infant mortality compared to states that do not participate in the program.
The discoveries from these studies highlight the benefits of Medicaid expansion. After the recent elections, a number of states move closer to expanding coverage and making a difference in nearly half a million lives.
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