The blue wave that Democrats hoped for and Republicans feared may not have been as strong as expected, but in the midterm elections Tuesday Americans voted overwhelmingly for preserving and expanding the existing system of health care.
With Democratic control of the House, the GOP no longer has legislative means to repeal the Affordable Care Act or reduce Medicaid and Medicare spending.
But perhaps the biggest winner: Medicaid and the expansion, which emerged in 2010 as part of the ACA, the proper name for Obamacare.
Idaho, Utah, and Nebraska, three traditionally red states, voted to expand Medicaid. Under the law, states that wish to may expand Medicaid to cover all people with household incomes below a certain level, and receive matching federal funds. This will cover around 300,000 low-income people, according to estimates.
Maine voted to expand Medicaid in 2017, but until now hadn’t been able to push the legislation through because Gov. Paul LePage, a Republican did not want to. Now, however, Maine and its new Democratic governor will be complying with the binding referendum. (LePage is moving to Florida — which is one of the 14 states that still has not expanded.)
The three states join 34 states and DC, which had all decided to expand Medicaid. Much of the south and part of the middle of the country are not.
While it already had passed a Medicaid expansion in 2015, Montana only funded it through 2019 and had a ballot initiative to raise funds through a tobacco tax. The tax was voted down, putting Medicaid for 100,000 low-income Montanans in jeopardy, according to advocates. The fight against the tax was backed by Big Tobacco giant Altria.
The other major GOP threat to the ACA — specifically its protection of pre-existing conditions — has been the lawsuit filed by 20 states and supported by the Trump administration. (The AGs argue that because the Supreme Court upheld the ACA in 2012 by saying its requirement to carry insurance was a legitimate use of Congress’ taxing power, eliminating the tax penalty for failure to have health insurance – known as the individual mandate – makes the entire law unconstitutional.)
One of the lawsuit’s architects and key players, Wisconsin’s Attorney General Brad Schimel, lost his seat as his state turned blue. Democrat Josh Kaul, the winner in that race and a former federal prosecutor, has slammed the lawsuit, saying it is not in the interest of Wisconsinites. A quarter of adults under 65 have pre-existing conditions.
Adding this to the equation along with the fact that two states in the lawsuit — Nebraska and Utah — voted to expand Medicaid, the ACA won big.
At the same time, however, Republican Josh Hawley, who led the suit for Missouri as attorney general, won that state’s Senate seat.
The lawsuit, which is in a federal court in Texas, was supposed to be decided quickly but will likely drag on and reach the Supreme Court.
From a market, analyst notes from Bank of America, Deutsche Bank and others said this newfound certainty makes the health care sector winners too. The split chamber means stability and the potential for further legislation to stabilize existing legislation.