Medicaid, Medicaid, Medicaid. It hasn’t been the dominant national theme, even in an election season dominated by health care, but Medicaid has more on the line tonight than any other area of health policy.
By the numbers: 17 states haven’t adopted the Affordable Care Act’s Medicaid expansion.
- 3 of those 17 states (Idaho, Nebraska and Utah) have initiatives on the ballot today to expand Medicaid.
- 6 more have gubernatorial races rated as toss-ups by the Cook Political Report (Florida, Georgia, Kansas, Oklahoma, South Dakota and Wisconsin).
- If all 9 of those states ended up expanding Medicaid, more than 1.6 million people would be newly eligible for coverage, according to the Kaiser Family Foundation’s estimates.
That’s an upper bound, obviously — it’s by no means safe to assume all of these states will end up expanding. But Florida alone could cover more than 700,000 new people; the universe of possible coverage gains here is large, even without a clean sweep.
Two expansion states also face big decisions tonight.
- Maine’s gubernatorial race could determine whether it actually implements the expansion voters approved last year.
- Montana voters will decide whether to retain the Medicaid expansion, relying on a tobacco tax to pay for the state’s share of the costs. Tobacco companies have spent millions urging Montanans to not to renew the expansion.
The bottom line: Expanded Medicaid coverage, much of it in red or purple states, is one of the most consequential on-the-ground changes these midterms could produce.