3 red states just expanded Medicaid —here's what the midterm election means for healthcare

The 2018 midterm elections will have some big healthcare consequences.

Democrats won control of the House of Representatives while Republicans strengthened their hold on the Senate. That means Washington gridlock could prevent any big legislative changes.

Also likely off the table is repeal of the Affordable Care Act or big cuts to Medicaid, which were narrowly defeated in the Senate last year.

“We continue to believe a split Congress is the best case scenario for the healthcare sector because it likely means legislative gridlock for the next two years,” Cowen analysts Eric Assaraf and Rick Weissenstein wrote in a note Wednesday. “Most notably, it likely puts Obamacare repeal efforts on the shelf until at least 2020, to the relief of hospitals and Medicaid managed care companies.”

Some of the biggest healthcare changes will likely come on the state level. Voters in three states voted to make more low-income people eligible for their state Medicaid programs under the Affordable Care Act. Democratic victories in governor races in states like Wisconsin and Kansas could lead those states to expand Medicaid, too.


Read more: Midterm key takeaways: Trump’s message flops, and Democrats set the stage for 2020

In other states, voters rejected major changes to the way healthcare is paid for and administered, and passed new anti-abortion measures. Here’s a roundup of the results.


Three red states voted to expand Medicaid.

Residents of Idaho and Nebraska voted to to broaden access to their state Medicaid programs to more low-income people, in line with actions taken by 34 other states and Washington, DC under the Affordable Care Act.

A similar proposal in Utah is projected to pass, with 54% of the vote, but ballots are still being counted in the state.

If voters in all three states choose to expand eligibility for Medicaid, roughly 325,000 more people could gain access to the health program, according to Avalere.

In Montana, voters rejected a proposal to raise taxes on tobacco products and make Medicaid expansion permanent, with 55% opposing it. That means the state’s Medicaid expansion is scheduled expire next year.


Utah and Missouri voted to legalise medical marijuana.

Several states took up the issue of both recreational and medical marijuana.

In the end, Utah and Missouri voted to legalise medical marijuana, while North Dakota voted down a measure that would legalise its use recreationally. Michigan, however, became the first Midwestern state to legalise recreational marijuana.


Alabama and West Virginia supported new anti-abortion measures.

Voters in Alabama and West Virginia supported measures to explicitly ban abortion in their state constitutions. Both already have abortion bans in state law as well, according to Governing.com, though the bans can’t be enforced because of the Supreme Court’s Roe v. Wade decision.

Alabama’s Amendment 2 passed with the support of 59% of voters. The tally was closer in West Virginia, where 51.7% voted for Amendment 1.

Oregon, meanwhile, rejected a proposal to prohibit the use of public funds for abortion, except in cases where a doctor determines that the procedure is necessary, or in cases where federal law requires the state to pay for an abortion. The measure would have stopped the state’s Medicaid program from covering abortions for low-income women.

About 64% of voters opposed the Oregon measure.


California rejected limits on payments to dialysis providers.

One of the biggest fights in healthcare went down in California.

Voters there rejected a proposition that would limit the amount of money dialysis providers make, after heavy spending by the industry. About 62% of voters opposed the measure.

Dialysis helps patients whose kidneys aren’t working properly filter impurities out of the blood (healthy kidneys would remove those impurities).

The process can be expensive – Medicare nationally spends $US34 billion a year on the treatment.

If Proposition 8 had passed, DaVita, one of the largest providers of dialysis, would have lost $US450 million a year, California Healthline reported.

About $US111 million had been raised to defeat the bill, the Washington Examiner reported. Of that, DaVita contributed $US66 million while rival Fresenius has contributed $US33 million.

DaVita, Fresenius, and American Renal gained in the stock market on Wednesday.


Massachusetts defeated a ballot measure to limit the number of patients assigned to nurses in hospitals.

Massachusetts voters soundly rejected Question 1, which would have placed limits on the number of patients nurses are assigned in the hospital. About 70% voted against the proposal.

The idea was that by limiting the number of patients, it could keep nurses from getting overwhelmed and improve care.

Vermont Senator Bernie Sanders endorsed the measure. “Question 1 would set a safe maximum on the number of patients nurses can treat, so that patients can receive the quality care they deserve,” Sanders said in a statement.

Hospitals opposed the measure, arguing that the limit would lead to increased medical costs and less flexibility, in part because they’d need to hire more nurses.


Maine voted down a proposal to increase taxes to pay for care for seniors.

Maine voters rejected a measure that would have increased taxes to fund care for elderly people in their homes. About 63% opposed the proposal.

Maine’s Question 1 would have levied a 3.8 per cent tax on income above $US128,400. The money would be used to pay for in-home care for all people 65 and over who need it in the state.

The measure would have raised taxes on about 10 per cent of Maine residents, and generated about $US310 million a year, according to the Portland Press Herald.


Oklahoma, Georgia, and Nevada also had healthcare issues on the ballot.

Voters weighed in on a number of other healthcare measures across the country.

In Oklahoma, the vote was too close to call on a proposal to let places like Walmart and Costco give eye exams. Forty seven other states allow the practice.

Georgia passed a ballot referendum that would help nonprofits in the state provide housing for those living with mental illnesses.

Nevada voters passed a proposal to make medical equipment – like oxygen tanks and wheelchairs – exempt from taxation.

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