While many Republican governors have refused to expand Medicaid, some conservative-led states may have to resign themselves to letting direct democracy decide the question, thanks to the efforts of advocacy groups across the country.
In Nebraska last week, advocacy group Insure the Good Life announced that it had received the number of required signatures for a November ballot initiative that will put it to the voters whether to expand access to Medicaid for 90,000 low-income Nebraskans. The group collected 133,000 signatures, almost 60 percent more than the approximately 85,000 necessary. Insure the Good Life is supported by several Nebraska groups, but is mostly funded by the Washington, D.C.-based Fairness Project, a group working to get Medicaid expansion on the ballot in states across the country.
Similar efforts backed by the Fairness Project are underway in Idaho and Utah. Idaho, like Nebraska, still needs to validate petition signatures; the expansion measure will appear on the ballot in Utah this fall.
But even if a state's voters decide to expand health care, that doesn't mean the state government will necessarily respect the vote. In Maine, about 60 percent of voters elected to expand Medicaid, but Republican Governor Paul LePage is steadfastly refusing to allow the expansion—even in the face of a state judge’s order to stop stalling and to comply with the outcome of the popular vote.
While Nebraska Republican Governor Pete Ricketts's re-election campaign spokesperson said that the expansion decision “ultimately rests with Nebraska voters,” the state legislature’s cooperation is even less certain. Medicaid expansion has failed repeatedly over the past six years in the Nebraska Legislature, and two Republican state senators have already sued to block the measure from appearing on the ballot.
The efforts to get Medicaid expansion on state ballots is an example of increased progressive grassroots action in conservative-led states, from canvassing for thousands of signatures to raising awareness about how expansion would bring federal dollars into Nebraska and provide health coverage to the poor.
Marea Bishop, an advocate for Insure the Good Life's petition drive, wrote an op-ed in the Omaha World-Herald describing how her health condition keeps her from holding steady work and her own inability to afford health insurance.
“Our communities can no longer wait while our Nebraska lawmakers fail to solve this public health problem,” she wrote. “We can do what our lawmakers have chosen not to do: to give our neighbors, our co-workers, our fellow Nebraskans a chance at a healthier life.”
