Deborah Dion and other protesters gather in the office of Florida State Rep. Manny Diaz as they protest his stance against the expansion of healthcare coverage on September 20, 2013 in Miami, Florida.
Joe Raedle/getty

Medicaid expansion on the line in many key races

We’ve probably all seen comparisons between the 2014 elections and “Seinfeld” – it’s the campaign cycle about “nothing.” The analyses are understandable, given just how little focus there’s been on anything resembling substance. Quick quiz: name the defining issue of this year’s elections.
 
If you said, “Ebola-carrying terrorists hiding in Mexico,” you appreciate just how vapid much of this campaign season has been.
 
But for many Americans, a great deal is at stake today. These families may not get a lot of attention, and they may not be as fascinating to political reporters as Bruce Braley’s neighbor’s chickens or Alison Lundergan Grimes’ 2012 presidential preference, but they’re probably wondering today whether the election results will allow them to receive affordable medical care.
A lot of attention has been paid to what a shift in control of the Senate in the midterms might mean for the Affordable Care Act and other big policy issues. As ACA implementation has shifted to the states, governor’s races may be just as important, particularly when it comes to whether states expand Medicaid.
 
Six of the 23 states that have not expanded Medicaid have toss-up governor’s races: Alaska, where Republican incumbent Sean Parnell is running against independent Bill Walker; Florida, the most closely watched race, where former governor Charlie Christ, now running as a Democrat, is trying to unseat Republican Gov. Rick Scott; Georgia, where incumbent Republican Nathan Deal is trying to hold off Democratic state legislator Jason Carter; Kansas, where state legislator Paul Davis is challenging Gov. Sam Brownback; and Wisconsin, where Gov. Scott Walker is being challenged by Mary Burke; and Maine, where Democratic state legislator Mike Michaud and independent Eliot Cutler are running against Gov. Paul LePage.
To be sure, it’s not automatic – in most of these states, a new governor who supports Medicaid expansion (and arithmetic) will still need support from state legislators – but a change in the governor’s office will offer new hope for low-income families currently stuck in the Republican-imposed “coverage gap.”
 
Conversely, a GOP win in these gubernatorial races all but guarantees struggling families will go without coverage.
 
Jason Millman had a good piece on this yesterday.
Democratic candidates are unanimous in their support for expanded Medicaid programs, which is not mandatory for states, thanks to a Supreme Court ruling in 2012. But a victory for Democratic gubernatorial candidates on Tuesday doesn’t guarantee they’ll be able to overcome opposition from lawmakers where Republicans control statehouses. Just ask Virginia Gov. Terry McAuliffe, who’s now pursuing a much more modest expansion amid continued GOP opposition in his state.
 
On the other hand, some Republican governors winning re-election on Tuesday could see the political clearance to pursue coverage expansion and the billions of dollars in federal funding that come with it.
Millman added that a few red-state Republican incumbents who’ve expressed interest in Medicaid expansion are all expected to win fairly easily today and with re-election behind them, “2015 could be the year these governors – and others – feel like it’s safe enough, politically speaking, to push for the expansion.”
 
And that’s not “nothing.”
 

Medicaid

Medicaid expansion on the line in many key races