These are the states where The People will vote whether to expand Medicaid

By Evie Fordham

At least four states — Utah, Idaho, Montana and now Nebraska — will have November ballot initiatives letting voters decide whether to join the 34 other states that have expanded Medicaid.

Nebraska’s ballot initiative was approved Wednesday when its state Supreme Court rejected “a last-minute appeal seeking to block” the proposal, the Lincoln Journal Star reported Wednesday.

Individual states have been able to expand Medicaid to cover more low-income residents since the Affordable Care Act (ACA) was passed in 2010, according to The Washington Post. Medicaid expansion was fully federally funded until 2016, but states that elect to expand Medicaid must foot 10 percent of the bill by 2020, reported WaPo.

Residents of the four states will have the chance to vote on whether they want Medicaid expansion, which helps those who make up to 138 percent of the federal poverty level get health coverage. Many of the adults in the so-called coverage gap don’t qualify for Medicaid without expansion, but find ACA exchange plans difficult to afford.

Blue states tended to adopt Medicaid expansion while red states were more wary of the costs the program posed.

Republican Ohio Gov. John Kasich pushed his state to adopt Medicaid expansion in 2013 and 2014. He touted the results of the program with an August report declaring that “an estimated 290,000 Ohioans utilized Medicaid expansion, and then transitioned off because they got a job or a raise,” Kasich tweeted on Aug. 21.

Utah, Idaho and Nebraska voters will get to choose whether they want their state to follow Ohio’s lead, while Montana residents will vote on extending its experimental Medicaid expansion that was adopted in 2015. Montana’s Medicaid expansion has a 2019 sunset date.

The ballot initiative to extend Montana’s Medicaid expansion provides for a tobacco product tax hike to offset the cost of expanding health coverage for low-income Montanans.

Tobacco companies like Virginia-based Altria have spent more than $9 million to convince voters to say “no” to the initiative, reported The Washington Post. But many Montanans may already favor the initiative, as nearly 10 percent of state residents get coverage through Medicaid expansion. That’s roughly 100,000 people out of the state’s population of approximately one million.

If the initiative passes in November, the tobacco tax increases could generate nearly $75 million annually by 2023, reported The Associated Pressin April.

The ballot initiatives could affect an estimated 90,000 adults in Nebraska, 150,000 in Utahand up to 60,000 people in Idaho.

Content created by The Daily Caller News Foundation is available without charge to any eligible news publisher that can provide a large audience. For licensing opportunities for this original content, email

Image courtesy of Wikimedia Commons/Public domain