Medicaid Expansion Updates: Idaho, Maine, Neb., Utah and Va.

Virginia Legislature Votes for Expansion

On May 30, the Virginia Senate voted, with 4 Republicans supporting the measure, to expand Medicaid eligibility to all individuals with income at or below 138 percent of the federal poverty line, according to the Washington Post. Later in the day, the House of Delegates approved the bill by 67 to 31. Gov. Northam, a pediatrician who campaigned in 2017 on expanding Medicaid, is expected to sign the bill.

On Jan. 1, 2019, Virginia will join 32 other states and the District of Columbia in adopting this state option provided by the 2010 Affordable Care Act. The bill adopted calls for work requirements and imposing premiums for individuals above the poverty line but the details are not yet worked out. The expansion is expected to add coverage for 400,000 Virginians, increasing state enrollment by 40 percent over the current enrollment of roughly one million. 

Maine Expansion Still Held Up by Gov. LePage

Maine voters approved Medicaid expansion in a ballot initiative in 2017 but Gov. LePage has refused to go forward, saying the legislature has to approve the necessary funding first. The legislature and governor have disagreed over the costs, with the governor's office estimating double the legislature, according to an Associated Press article. The ballot measure called for implementation by July 2, 2018. The governor is term-limited and the election of his replacement will be in Nov. 2018. It may be up to the new governor to solve the impasse. 

Expansion Ballot Measures in Utah and Idaho

Enough signatures have been gathered in the two western states of Utah and Idaho to put Medicaid expansion on the ballots in Nov. 2018. Estimates for new coverage are 150,000 in Utah and 62,000 in Idaho.

Utah already has a federally approved waiver to expand coverage to a small number of persons who are chronically homeless and have mental illness and substance use disorders and other behavioral health problems. A second Utah waiver awaiting federal action proposes to limit eligibility to 100 percent of poverty, as well as impose work requirements. 

Nebraska Ballot Drive Under Way

The  campaign to put Medicaid expansion on the Nov. 2018 ballot is still under way in Nebraska. Supporters say they are on track to gather the necessary signatures by July 5. Gov. Ricketts, who is running for re-election, has opposed Medicaid expansion but has not said if he would try to override it if approved by voters. His Democratic opponent, Bob Krist, is in favor of expansion, according to a recent article in Governing. 

Current Map of Medicaid Expansion 

The Kaiser Family Foundation maintains a status map of Medicaid expansions here. The map below has not been updated to show the Virginia legislative action taken on May 30, 2018. The shading for Maine shows the pending implementation of the 2017 ballot initiative.