Campaigns to expand Medicaid via the ballot box are gaining momentum in two more Republican-leaning states where lawmakers and governors have blocked efforts to expand health insurance coverage to more Americans.
The latest momentum to expand Medicaid coverage for the poor came last week in Missouri with the launch of Healthcare for Missouri, a coalition of healthcare providers, businesses and other supporters working to win support of a referendum that they are working on for the November 2020 general election. The Missouri effort follows a campaign to win support in Oklahoma for a ballot initiative in the works there.
The hope by supporters of Medicaid expansion is that voters in Missouri and Oklahoma will follow the lead of successful ballot initiatives last year in Nebraska, Idaho and Utah. Those states, like Maine in 2017, bypassed Republican governors and legislatures to expand Medicaid by public referendum.
The Fairness Project, which spent $ 6 million to support ballot measures that won last November of 2018, has been evaluating the political and regulatory climate of the 14 remaining states yet to expand Medicaid under the Affordable Care Act.
“This is going to be another health care election,” Jonathan Schleifer, executive director of The Fairness Project said of the 2020 ballot campaigns.
“The pro-health care wave that swept the country in 2018 was just the first leg of a relay — and voters in Oklahoma and Missouri are taking up the torch,” Schleifer added. “Americans are tired of having to choose between putting food on the table and paying for lifesaving care — and they’re going to continue to vote for change. These campaigns are a clear sign that the movement to protect and expand access to health care has only grown stronger since the 2018 election.”
The expansion of Medicaid benefits under the ACA has come a long way since the U.S. Supreme Court in 2012 gave states a choice in the matter. There were initially only about 20 states that sided with President Barack Obama’s effort to expand the health insurance program for poor Americans.
The 14 holdout states that remain have already missed out on generous federal funding of the Medicaid expansion. From 2014 through 2016, the ACA’s Medicaid expansion population was funded 100% with federal dollars. The federal government still picks up 90% or more of Medicaid expansion through 2020. It’s a better deal than before the ACA, when Medicaid programs were funded via a much less generous split between state and federal tax dollars.
Such expansion has been a boon to health insurers like Anthem, Centene, UnitedHealth Group and CVS Health’s Aetna health insurance unit given these private insurers generally administer most Medicaid benefits in the U.S.
In the Missouri campaign and the “Yes on 802” effort in Oklahoma, supporters are highlighting the loss of billions of dollars in federal funding that could be a boon to state coffers that is, instead, going to the other 36 states that did expand Medicaid or remaining in Washington.
Healthcare for Missouri “will ask voters to bring home more than a billion of Missourians’ tax dollars from Washington, D.C., every year to keep rural hospitals open, boost the state’s economy, and deliver healthcare to people who have lower-paying jobs that don’t come with insurance,” Healthcare for Missouri said in its campaign launch.
In Oklahoma, Medicaid expansion would bring coverage to nearly 200,000 Oklahomans.
“It will deliver healthcare to those who need it, including many parents, seniors, and hardworking folks who earn less than $ 17,000 a year,” Oklahomans Decide Healthcare, the group pushing the “Yes on 802” measure, says on its web site. “It will also bring more than a billion of our tax dollars home from Washington, D.C. every year to create jobs, boost our economy, and keep our rural hospitals open. That’s money that 36 other states that have expanded Medicaid get, but Oklahoma has lost out on for years.”
Both efforts already have an array of supporters, including doctors, hospitals and patient groups.
“Medicaid expansion is the right thing to do for the people of our state,” Rick Stevens, president of Christian Hospital in St. Louis said last week. “It’s the fiscally responsible thing to do as well.”