Spotlight Exclusives

Medicaid Tops Poverty-Related Issues in Governor Races

Spotlight Staff Spotlight Staff, posted on

Medicaid expansion and possible work requirements for Medicaid recipients are the two key poverty-related issues most at stake in November’s gubernatorial elections, a Spotlight tracker for all 36 races finds.

Six of the 17 states that didn’t expand Medicaid after passage of the Affordable Care Act in 2010 have competitive governor’s races in which the Democratic candidate supports expansion and the Republican candidate opposes. They are:

  • Florida: Ron DeSantis (R) vs. Andrew Gillum (D)
  • Georgia: Stacey Abrams (D) vs. Brian Kemp (R)
  • Kansas: Laura Kelly (D) vs. Kris Kobach (R)
  • Oklahoma: Drew Edmonson (D) vs. Kevin Stitt (R)
  • South Dakota: Kristi Noem (R) vs. Billie Sutton (D)
  • Wisconsin: Tony Evers (D) vs. Scott Walker (Incumbent, R)

A recent Kaiser Family Foundation poll found that 56 percent of people in the 17 states that did not opt for Medicaid expansion support the policy.

Three other states – Idaho, Nebraska, and Utah – have ballot initiatives that would expand Medicaid coverage. And in Maine, voters will elect a new governor to replace Republican Paul LePage, who has blocked implementation of a 2017 ballot initiative that approved Medicaid expansion in the state. LePage argued that Maine lacks adequate funds to finance the expansion. Democratic candidate Janet Mills has said she would implement Medicaid expansion on her first day in office, while GOP candidate Shawn Moody told the Washington Post recently that he would move forward with Medicaid expansion if there is “sustainable and responsible funding from the legislature.”

In Montana, ballot initiative I-185 would raise taxes on all tobacco products in order to fund and extend Medicaid expansion. If the measure fails, the state’s 2015 Medicaid expansion, which has enrolled nearly 100,000 people, would expire on June 30, 2019.

Another set of states with gubernatorial elections this year – Arizona, Kansas, Michigan, Ohio, South Dakota, and Wisconsin – are seeking waivers to establish work requirements for Medicaid recipients, a process that could be impacted by election results. In Arkansas, the administration of incumbent Asa Hutchinson (R) successfully sought a waiver to institute work requirements earlier this year, a policy that has resulted in the removal of more than 8,000 Arkansans from the Medicaid rolls in its first two months. In a recent debate, Hutchinson’s Democratic challenger Jared Henderson said the work requirements should be ended as improved healthcare helps low-income Arkansans be more effective in seeking work.

Medicaid expansion has become a key issue in the Georgia gubernatorial election, a race closely watched by both parties for its potential national implications. A Robert Wood Johnson Foundation analysis estimated that nearly half a million Georgians could be added to the Medicaid rolls through expansion, but incumbent Gov. Nathan Deal (R) has opposed such a move because of fears of excessive costs to the state budget.

Kemp shares those concerns, saying that Medicaid “costs too much and fails to deliver for hardworking Georgians.” In a debate Tuesday night, Kemp said Abrams’ call for Medicaid expansion would amount to “a government takeover of health care,” doing away with private insurance, as well as Medicare. “You will not be able to choose who your doctor is,” he said.

Abrams, however, has made support for Medicaid expansion one of the key policy planks of her campaign, arguing that the policy would pay particular dividends in rural areas, where it’s been shown to not just expand coverage but also bring economic stability to struggling rural hospitals. Eight rural Georgia hospitals have closed in the last decade.

On another poverty-related issue, Abrams supports passage of a Georgia Earned Income Tax Credit that would allow qualified residents to seek credits totaling at least 5 percent of the federal credit. It would cost $150 million, and she would pay for it by eliminating “tax loopholes.”

Twenty-nine states and the District of Columbia have enacted EITCs. Only taxpayers eligible for the federal credit can receive the state credit and state EITCs ranging from 3.5 percent to 40 percent of the federal credit.

For more on where every gubernatorial candidate stands on poverty-related issues, check out Spotlight’s 2018 election tracker.

« Back to Spotlight Exclusives