Red states vote for blue policy: Nebraska, Idaho and Utah voters expand Medicaid over GOP objections

Candidates who wanted to expand Medicaid fell short in Florida, Texas and Ohio

Published November 13, 2018 6:00AM (EST)

A volunteer hands out a poster as Vermont independent Sen. Bernie Sanders was set to address a “Medicare for All” rally in downtown Columbia, S.C. on Saturday, Oct. 20, 2018 (AP/Meg Kinnard)
A volunteer hands out a poster as Vermont independent Sen. Bernie Sanders was set to address a “Medicare for All” rally in downtown Columbia, S.C. on Saturday, Oct. 20, 2018 (AP/Meg Kinnard)

Millions of voters decided on the future of healthcare policy in America on November 6, as Democrats reclaimed control of the House of Representatives while Republicans expanded their majority in the Senate. Across the country, healthcare was a top issue for voters as they cast their ballots on issues such as Medicaid expansion.

In three traditionally conservative states, voters passed ballot initiatives to adopt the Affordable Care Act's expansion of the Medicaid program. 

Idaho voters approved Medicaid expansion with 60 percent of the vote, while Nebraska and Utah approved Medicaid expansion with 54 percent and 53 percent, respectively. More than 300,000 residents across Nebraska, Idaho and Utah are likely to gain access to health care coverage as a result of the approval measures. The number of states with Medicaid expansion now totals 37 states, including the District of Columbia.

The Democratic Party also won competitive gubernatorial races in Kansas, Wisconsin and Maine, setting the table for Medicaid expansion in those states. Kansas' state legislature voted to approve Medicaid expansion in 2017, only to have it vetoed by Gov. Sam Brownback. For Gov.-elect Laura Kelly, extending and expanding the program was a huge part of her campaign — and while she came out on top, she faces a state legislature that is even more conservative than it was before the election. In Wisconsin, Tony Evers, who narrowly defeated Republican incumbent Gov. Scott Walker, also campaigned on a platform that included Medicaid expansion. In Maine, Gov.-elect Janet Mills vowed to expand Medicaid as voters demanded in 2017, just after defeating Republican businessman Shawn Moody.

Meanwhile, in other states, last Tuesday' results threaten the future of healthcare policy.

In Florida, Tallahassee Mayor Andrew Gillum, who embraced Medicare for All, lost a tight gubernatorial contest to Republican Rep. Ron DeSantis. (Gillum recently retracted his resignation amid a recount in the state.) Voters in Alaska elected a new Republican governor, Mike Dunleavy, who has previously criticized the costs of Medicaid expansion. Alaska's outgoing Independent Gov. Bill Walker expanded Medicaid in 2015 and has warned that Dunleavy could unravel Medicaid expansion, which covers 45,000 Alaskans.

Tuesday night's results also threaten Medicaid expansion in Montana, where voters rejected a ballot measure that would have expanded the program. In 2015, lawmakers in the Treasure State expanded Medicaid by a close vote. The 2015 measure passed with the condition that eligibility for coverage in the state would expire in 2019 unless lawmakers voted to keep it going. Once it expires, Medicaid recipients who got coverage under the expansion would lose it. Fast forward to 2018: legislators came up with a ballot measure to keep Medicaid funding going by asking voters to pay for it with a tobacco tax. Montana voters rejected it by a 53 percent to 47 percent vote.

In Texas, Rep. Beto O'Rourke, who called for expanding Medicaid, fell short in the Senate race.

There are better news for expansion advocates in Vermont and Washington, where Sen. Bernie Sanders, I-VT, and Rep. Pramila Jayapal, D-Wash., — two of the most vocal advocates of Medicare for All — were re-elected. And in New York, democratic socialist Alexandria Ocasio-Cortez, a political novice who ran on a Medicaid for All platform, was elected to Congress in the state's 14th Congressional District. Ocasio-Cortez also became the youngest woman ever elected to Congress.

In Ohio, Rep. Troy Balderson, a former GOP state lawmaker who won short-term control of the 12th District seat in an August special election, defeated Democrat Danny O'Connor, the Franklin County recorder, in a tight race for the 12th district seat left open by long-serving Republican incumbent Pat Tiberi. Health care was a major issue in Ohio's 12th congressional district, as seen in a fiery debate before Election Day during which O'Connor probed Balderson about how he could claim not to be taking away his constituents' healthcare coverage while he opposing expanding Medicaid, which nearly three million of Ohioans rely on.

By Shira Tarlo

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2018 Midterm Election Aca Affordable Care Act Democrats Healthcare Idaho Maine Medicaid Nebraska Senate Utah