Nebraskans voted Tuesday to expand Medicaid under the Affordable Care Act via ballot initiative, overcoming years of Republican opposition by GOP state legislators and Gov. Pete Ricketts.
With more than 53% support with 90% of precincts reporting, Nebraska followed the lead of voters in Maine who last November approved Medicaid expansion by public referendum.
Supporters of Nebraska’s Medicaid expansion put it on Tuesday’s ballot after their Republican-leaning legislature and Ricketts have been roadblocks to providing more health coverage to the state’s poor.
But Tuesday’s support of Medicaid expansion means most Republican Nebraska legislators and Ricketts were ignoring their constituencies on a key healthcare issue. Ricketts regularly urged legislators to defeat Medicaid expansion as a key part of Obamacare.
“This election proves that politicians who voted to repeal the Affordable Care Act got it wrong,” said Jonathan Schleifer, executive director of The Fairness Project, which supported the “Initiative 427” campaign to expand Medicaid in Nebraska.
“Americans want to live in a country where everyone can go to the doctor without going bankrupt. Expanding access to health care isn’t a blue state value or a red state value; it’s an American value.”
Ricketts, who won re-election Tuesday to a second term as Nebraska’s governor, will now have to preside over expanding Medicaid under a health law he has long opposed. The Omaha World-Herald reported Tuesday night Ricketts “has not yet indicated what posture his administration would take toward implementation of the initiative should it pass.”
This fall’s campaign may have turned on the financial and economic benefits to expanding Medicaid. In Nebraska, not expanding Medicaid has meant a loss of hundreds of millions of federal dollars in the state.
But the passage of Nebraska’s “Initiative 427” will bring “nearly $600 million a year back to Nebraska from Washington, D.C. ,” Insure The Good Life, a group supporting the ballot measure has said, citing a new national study.
“This influx of federal funding would create and sustain nearly 11,000 jobs and generate $1.3 billion in economic activity across the state.”
Since Nebraska voted to expand Medicaid, 45,000 will gain coverage and the uninsured rate will fall to 9.6% from 12.4% next year, according to a study earlier this year by the Urban Institute.
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 then President Barack Obama’s effort to expand the health insurance program for poor Americans.
The 17 hold out states like Nebraska that remained before Tuesday’s midterm elections 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.
Since last year, 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.