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Post-Election Medicaid Expansion Possible in Some Red States

Democrats flipped seven governor seats in the midterm elections, opening the door for Medicaid expansion in several previously Republican-held states, including Kansas, Maine, and Wisconsin.

In Kansas, Democratic Governor-elect Laura Kelly has promised to advocate for legislation approving Medicaid expansion during her first year in office. Republicans continue to control both chambers of the state’s legislature, but they have supported expansion in the past. In 2017, expansion legislation received bipartisan support in the state House and Senate but was vetoed by Gov. Sam Brownback (R).

In Maine, Democratic Governor-elect Janet Mills indicated she will move quickly to implement Medicaid expansion, more than a year after voters approved doing so. The state legislature is expected to support her effort as Democrats won control of the state Senate in the midterm elections, giving the party control of both chambers.

Democratic Governor-elect Tony Evers, of Wisconsin, said he will take immediate action to expand Medicaid. However, Republicans in the state legislature control both chambers; lawmakers previously opposed expansion and could challenge Evers’ action.

Voters in Three Red States Elect to Expand Medicaid

Four red states — IdahoMontana, Nebraska, and Utah — saw Medicaid expansion on the ballot in the midterm elections. Each ballot initiative was championed by grassroots efforts from residents, with  support from hospitals, providers, patient advocates, and others.

Voters approved Medicaid expansion in Idaho, Nebraska, and Utah, increasing coverage for more than 300,000 people, collectively. These states now will begin planning how to fund and implement  expansion.

Montana voters rejected an initiative to extend the state’s Medicaid expansion. The ballot initiative proposed raising taxes on tobacco products to fund the continuation of the expansion, which is set to expire on June 30, 2019.

Contact Senior Director of Policy Erin O’Malley at or 202.585.0127 with questions.


About the Author

Kelcie Jimenez is a state policy analyst at America's Essential Hospitals.

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