More on Policy and Legislation

Medicaid expansion gains passage in three states

Utah, Idaho and Nebraska passed petitioned ballot measures to allow additional individuals to be covered under Medicaid.

Susan Morse, Managing Editor

Petitioned ballot measures for Medicaid expansion passed in Utah, Idaho and Nebraska on Tuesday, giving coverage to 325,000 people.

In Maine, where Republican Governor Paul LePage has stalled the implementation of Medicaid expansion approved by voters last fall, Democrat Janet Mills won the governor's seat.

Five states, which haven't expanded Medicaid, had hotly contested races for governor. Whether a Democrat or Republican won was seen as a deciding factor in eventual passage of Medicaid expansion.

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The vote was split. In two of those states, Kansas and Wisconsin, Democrats won the governorship. Republicans won the seat for governor in Florida and South Dakota. In Georgia, Republican Brian Kemp leads in a race not yet conceded by Democrat Stacey Abrams.


Medicaid expansion allows more people to gain healthcare coverage, lowering for hospitals the cost of uncompensated care and emergency room visits.


The results show that party does not matter to voters when it comes to healthcare, said Lyndean Brick, founder, CEO and president of The Advis Group.

The states that expanded Medicaid by petitioned ballot have long controlled by Republicans, who traditionally have not supported expanding the population covered under Medicaid, she said.

Voter consensus nationwide is for affordable healthcare and access for all, particularly for those with preexisting conditions, Brick said.

This election, 24 healthcare professionals ran for Congress, according to Brick. Of those, 18 were elected, with representation from both parties.

"I can't think of a better start to protect healthcare," Brick said.

They include former Health and Human Services secretary under President Clinton Donna Shalala, who won a House seat representing Florida, and Lauren Underwood who was elected from Illinois.

Underwood is a Democrat and a nurse with a heart condition who ran on the campaign of protecting pre-existing conditions, Brick said.

"She won in a Republican-leaning district and she won big," Brick said. "That says to me a lot. Healthcare is the issue in this election that matters."


Having Democrats control the House means there will be less  backsliding on the Affordable Care Act. No more repeal and replace attempts. Medicare and Medicaid budgets will be better protected, according to Brick.

Pre-existing conditions, "the third rail" of healthcare politics, will continue to be covered, she said. Expect limiting pharma prices to be the Democratic agenda. 

But with Republicans still in control of the Senate, Democrats will be unable to send any sweeping legislation such as Medicare-for-all, or even a restoration of the individual mandate, to President Trump's desk for veto, said Yulan Egan, practice manager at the Advisory Board.

Bipartisan work will continue to advance transparency, scrutinize consolidation, bolster rural healthcare facilities, address the opioid epidemic and advance updates to MACRA, she said.

The past six months alone have seen a redesign of the meaningful use program, now called promoting interoperability, an expanded requirement for hospitals to post standard charges online, site neutral payments and a delay in the overhaul of the evaluation and management payment.


"Affirmative votes on ballot initiatives in Idaho, Utah, and Nebraska to expand Medicaid demonstrate the value of Medicaid," said Matt Eyles, president and CEO of America's Health Insurance Plans. "AHIP and our Medicaid health plan members will continue to work with states to deliver coverage through programs that are effective, affordable and accountable to enrollees and hardworking taxpayers." 

"As voters took to the polls yesterday, healthcare was cited in poll after poll as the single most important issue in voters' minds. And they made their voices clear in favor of reliable, comprehensive coverage, regardless of their party label," said Margaret A. Murray, CEO of the Association for Community Affiliated Health Plans. "The rhetoric around Medicaid expansion is inevitably giving way to facts on the ground. We see that expanding health coverage improves access to care, leads to better health outcomes, lowers uncompensated care for healthcare providers, and helps people with low incomes stay out of crushing medical debt."

Twitter: @SusanJMorse
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