ADEA State Update

Medicaid Expansion on the Ballot in Idaho, Nebraska, Utah, and Montana

(State Policy, Insurance, Medicare and Medicaid, ACA, Medicaid Expansion) Permanent link   All Posts

Thirty-three states and Washington, DC, have expanded access to Medicaid under the Affordable Care Act. In most states, expansion took place through legislative action, but after November, three states may expand access through the polls. Medicaid expansion referendums are on ballots in Idaho, Nebraska and Utah, and a similar initiative to extend expansion beyond a scheduled sunset is on the ballot in Montana. Experts see the referendums as significant, as all four states are traditionally conservative and opposition to Medicaid expansion is most likely to occur. The referendums are polling in favor of the expansions in all four states.

In Utah, the expansion vote will compete against a partial expansion proposal that was passed by the legislature and signed by Governor Gary Herbert in March. The legislative plan would expand access to individuals who earn up to 100% of the federal poverty level, instead of 133% as prescribed by the Affordable Care Act. The partial expansion would also implement a work requirement for enrollees and would require approval of a waiver by the Centers for Medicare & Medicaid Services (CMS). CMS is not expected to make a determination on the partial expansion waiver until after the November midterm elections.

A similar referendum passed in Maine last November, but implementation has not occurred, as the state’s governor, Paul LePage, has refused to implement the program. Implementation in that state may soon begin, however, as Governor LePage was ordered by the Maine Supreme Judicial Court to submit plans for expansion to the federal government.

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