In Nebraska, Medicaid expansion will be on ballot in 2018 midterm vote

A Nebraska coalition said Thursday it submitted more than enough signatures to get Medicaid expansion on the ballot in November, making it the latest Republican-led state to seek ways around governors and legislators who oppose the key plank of Obamacare.

Insure the Good Life, which led the petition drive, said it submitted 133,000 signatures from across Nebraska to the secretary of state, exceeding the 85,000 valid signatures that are required.

Supporters of the initiative say that grabbing federal dollars under President Obama’s vision for expanding Medicaid, the federal-state insurance program for the poor, will cover 90,000 more Nebraskans and recoup roughly $1 billion in federal tax dollars over four years.

“Let’s bring that money home — money that is already going to states like Arkansas, Iowa and California,” said former state Sen. Kathy Campbell, who assisted the effort.

Obamacare called on all states to expand Medicaid to those making up to 138 percent of the federal poverty level, though the Supreme Court made it optional in 2012. While federal taxpayers pick up most of the burden, states will have to pay for 10 percent of the cost of the expansion population in 2020 and beyond.

Thirty-three states and the District of Columbia have expanded Medicaid coverage, though holdout states say the rising state share would bust their budgets. Other critics point to lingering GOP efforts to replace Obamacare with a more conservative program.

Nebraska Gov. Pete Ricketts, a Republican, has opposed expansion, saying it will be too costly and nudge out budget priorities, like property-tax relief or roads funding.

“Gov. Ricketts has expressed his concerns about diluting Medicaid’s focus on vulnerable Nebraskans by extending the program to able-bodied adults. The decision ultimately rests with Nebraska voters,” said Matthew Trail, a campaign spokesman for Mr. Ricketts, who is running for re-election in November.

Nebraska is among four states that have sought to place the issue directly before the voters, instead of pleading with policymakers.

Grass-roots activists in Utah and Idaho appear to have gathered enough signatures for similar ballot initiatives in their states, while Maine voters approved expansion in 2017.

Maine Gov. Paul LePage has blocked the expansion from proceeding until the Legislature finds a way to pay for the state share without raising taxes on families or businesses, using one-time budget “gimmicks” or raiding a budget-stabilization fund.

The Republican governor recently appealed a court order that said his administration must submit a plan for expansion to the federal Health and Human Services Department.

Nebraska’s petitioners said they weren’t able to put ways to fund the expansion before voters, because state law requires ballot initiatives to only cover one subject.

Andy Slavitt, who oversaw Medicaid under Mr. Obama, said while the funding standoff did slow down the Maine initiative, allowing voters to take the wheel might “do governors a favor” in red states.

“Medicaid expansion is good for a lot of these states for many reasons, but politically difficult to support,” Mr. Slavitt said. “Governors will get the jobs, rural hospitals, and health benefits without having to back or sign the law.”