Outcome of Midterm Elections Will Have Effect on Health Policy

The outcomes of Tuesday’s midterm elections could have a significant effect on health care policy, Modern Healthcare reports.

In particular, whichever party controls the U.S. Senate after the election has the power to shape the future of the Affordable Care Act. Republicans must gain six seats to take control of the chamber, and most predictions indicate that will happen, though a few races are very close, according to Modern Healthcare.

State Races Will Shape Medicaid Expansion’s Future

Beyond the senatorial races, the outcome of various state-level elections have the potential to strongly influence the future of Medicaid expansion (Demko, Modern Healthcare, 11/3).

States where Medicaid expansion could hinge on the elections’ outcomes include:

-South Dakota;
-Wisconsin; and
-Wyoming (Millman, “Wonkblog,” Washington Post, 11/3).

According to the Wall Street Journal’s “Washington Wire,” six of the 23 states that have not yet expanded their Medicaid programs have contentious gubernatorial races (Altman, “Washington Wire,” Wall Street Journal, 11/3).

In Maine, the outcome of both gubernatorial and legislative races could determine whether the state expands the program. Gov. Paul LePage (R), who is running to retain his position, has repeatedly blocked expansion, while his Democratic challenger has vowed to expand Medicaid if elected. Further, control of Maine’s Legislature, which is currently held by Democrats, could change. University of Maine political science professor Jim Melcher said, “I don’t think Republicans taking the state Senate would necessarily rule out Medicaid expansion,” but “[i]t would certainly make [expansion] more difficult.”

In other states, a change in power at the executive level could mean the state will reverse its Medicaid expansion. For example, Republican Asa Hutchinson, who currently has the lead in Arkansas’ gubernatorial race, and Doug Ducey, a Republican gubernatorial candidate in Arizona, both have remained noncommittal to continuing those states’ Medicaid expansions.

However, it would be “incredibly difficult” for a state to cease providing Medicaid benefits after it expanded the program, according to Avalere Health Vice President Caroline Pearson. She continued, “New governors in states that previously expanded Medicaid may pursue small changes to Medicaid over time that align with their political philosophy, but they are unlikely to fully repeal the expansion” (Modern Healthcare, 11/3).

Further, not all newly elected Republican governors would be automatically resistant to expanding Medicaid. According to “Wonkblog,” some GOP governor-elects could increase the program’s eligibility limits to take advantage of the influx of federal funding that comes with expansion (“Wonkblog,” Washington Post, 11/3).

Other State Health Care Initiatives

Meanwhile, ballot measures in various states address health policy issues such as ACA implementation and abortion.

For example, one California measure would give the state’s insurance commissioner the power to regulate health insurance premiums, including rates in the state’s insurance exchange, while an amendment to North Dakota’s constitution could limit women’s access to abortion and potentially other reproductive health services (Modern Healthcare, 11/3).

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