In three states, Nebraska, Idaho, and Utah, voters approved Medicaid expansion on election night.
Nebraska’s approval means an estimated 90,000 people will now be eligible for Medicaid coverage. The expansion will be funded 93% by the federal government for the first year and 90% in subsequent years, while the state will fund the remainder, estimated to be approximately $90 million for the next 3 years. Measures to expand Medicaid have been introduced in the Nebraska legislature for the past 6 years, but all failed. The deadline for the state to have an operational, fully expanded program is April 1, 2019.
Idaho’s expansion will expand coverage to 62,000 individuals. The measure received a boost in support following an endorsement by Republican Governor Butch Otter last week. While predominately federally funded, Idaho will be responsible for 10% of the cost from 2020 on. This funding will still need to be approved by the Idaho legislature, who has struck down expansion efforts for the last 4 years, before the expansion can be implemented.
Utah’s voters also approved Medicaid expansion, providing eligibility to approximately 150,000 individuals. As in Nebraska and Idaho, Utah will be responsible for 10% of the cost, while the federal government will fund the rest. Utah plans to increase the state’s sales tax by 0.15% (4.85% tax total) to pay for their portion of the expansion costs. The deadline for the state to have an operational, fully expanded program is April 1, 2019.
However in Montana, a ballot measure to renew the state’s Medicaid expansion was unsuccessful. The measure would have imposed a $2-per-pack tax on cigarettes, and raised the tax on snuff and vaping products, generating an estimated $74 million annually by 2023. The measure has heavily besieged by ad campaigns supported by the tobacco industry. Without further legislative action, Montana’s current Medicaid expansion will end in June 2019.
Additionally, Kansas is likely to implement expansion in the future following the election of Democrat Laura Kelly as governor. The state’s Legislature had previously attempted to expand, but the measure was blocked by former Republican Governor Sam Brownback.
Maine will also expand Medicaid coverage with the election of Democrat Governor Janet Mills. Mills has pledged to expand Medicaid on her first day in office. Maine voters had approved an expansion measure in 2017, but Republican Governor Paul LePage refused to implement the changes. LePage’s administration is currently involved in a lawsuit regarding their failure to implement the changes per the timeline set out in the law.
In Florida, the likelihood of future Medicaid expansion is uncertain with the recount of votes for the governor position. Under the initial vote count, Republican Ron DeSantis beat out Democrat Andrew Gillum. However, with the recount ongoing there is no clear outcome. Gillum had repeatedly expressed his support for Medicaid expansion in the state and the potential to implement Medicare for All, Bernie Sanders’ plan to create universal healthcare. DeSantis frequently criticized Gillum’s stance, stating that Medicaid expansion could lead to drastically higher taxes and would work to undo Florida’s post-recession developments.
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