A man holds a sign directing people to an insurance company where they can sign up for the Affordable Care Act, also known as Obamacare in Miami, Fla in 2015.
Photo by Joe Raedle/Getty

Health care was on the ballot in 2018, and it won big

It was just a few weeks ago when Senate Majority Leader Mitch McConnell (R-Ky.) said out loud what was widely assumed to be true: if Republicans held onto their congressional majorities, the GOP would try again to repeal the Affordable Care Act. Last week, Larry Kudlow, director of the White House National Economic Council, endorsed a similar strategy.

That plan is now dead. With Democrats retaking the House majority, the Affordable Care Act had a good day at the ballot box. Republicans may yet be able to undermine the nation’s health care system, but they’ll need to rely on the courts because voters just ended the repeal crusade.

For health care advocates, that’s just the start of the good news.

Three red states approved Medicaid expansion in Tuesday’s midterm elections, changes that will potentially cover hundreds of thousands more low-income Americans, NBC News projected.

Voters in Utah, Nebraska and Idaho were all expected to pass ballot measures to broaden the federal and state health insurance program, according to NBC.

All told, as a result of these ballot measures, more than 300,000 low-income Americans are poised to gain health care coverage. The new total of states that have embraced Medicaid expansion through the Affordable Care Act will now grow to 36.

It gets better: with Democrats winning big in Maine, and Gov. Paul LePage (R) exiting the stage, the future for Medicaid expansion in the state appears bright, and in Kansas, where voters elected a Democratic governor, it’s likely we’ll see the Sunflower State join the club.

To be sure, the news wasn’t all good for health care advocates. In Montana, where the tobacco industry spent more than $12 million to defeat a ballot measure, voters apparently rejected a funding mechanism to keep Medicaid expansion going in the red state. Its future in Montana is now uncertain.

But this was generally the only setback in what was otherwise a very good day for American health care. The challenges aren’t over – the Trump administration will still try to undermine “Obamacare,” and a Republican judge in Texas is poised to try to gut the law – but health care advocates have reason to celebrate today.