How This Month’s Elections Could Affect Low-Income Americans’ Access To Health Care

Louisiana gubernatorial candidate, state Rep. John Bel Edwards, D-72nd Dist., speaks at the Southeast Super Region Committee Gubernatorial Forum in New Orleans. CREDIT: AP PHOTO/GERALD HERBERT
Louisiana gubernatorial candidate, state Rep. John Bel Edwards, D-72nd Dist., speaks at the Southeast Super Region Committee Gubernatorial Forum in New Orleans. CREDIT: AP PHOTO/GERALD HERBERT

With all eyes on the ongoing 2016 presidential election, not many Americans are paying attention to the state elections happening this month. But voters from a few select states will be heading to the polls tomorrow and later in the month to elect new legislators and governors — among other things — in races that could potentially shake up their state’s Medicaid coverage in the process.

Obamacare’s Medicaid expansion remains optional for states, but, when implemented, has proven to be more successful at enrolling previously uninsured people than any private insurer — greatly depleting states’ uninsured rates. Currently, 31 states have agreed to expand their Medicaid rolls, insuring more than 4.3 million people.

But some candidates up for consideration this month have conflicting views on the current status of Medicaid expansion in their state, and, if elected, could drastically influence low-income residents’ access to affordable health care. Here are the states that could face Medicaid changes under new leadership this election:


If Matt Bevin, a Trump-esque millionaire investor and Kentucky’s Tea Party candidate for governor, wins this election, he’ll likely erase the acclaimed work state lawmakers have put into Medicaid expansion in the past year.


Unlike most southern states, Kentucky opted to expand Medicaid under Obamacare and create its own state exchange program, which effectively dropped the state’s uninsured rate from 20.4 percent in 2013 to 9 percent in the beginning of 2015. But Bevin has made it clear that he’d repeal Obamacare as soon as he took office, calling the entire law “a disaster.” And he’s pointed to the October collapse of the state’s leading exchange enrollment cooperative as validation for his Obamacare take-down campaign.

Bevin’s Democratic opponent, Kentucky Attorney General Jack Conway, has said he’ll stick with the state’s current health care plan, but has barely come out on top of Bevin in polls.


Virginia Gov. Terry McAuliffe (D) has been trying to move forward with Medicaid expansion ever since he was elected, but has been repeatedly thwarted by Republicans in the state legislature. Currently, Republicans hold the majority in both chambers, and will continue to have a two-thirds majority in the House.

But now, all 140 seats in both the House and Senate are up for election. If Democrats take the Senate lead in tomorrow’s election, which requires a mere one-seat win, a state fight for Medicaid expansion could finally take off. Since Virginia is a swing state for the 2016 presidential elections, some say that a win in Medicaid expansion could spark national change.


Senate Democrats who support Medicaid expansion — which would add 400,000 Virginians to the program — are also backed by the Virginia Hospital & Healthcare Association. This support adds a new economic angle to the discussion, since state hospitals have been up against growing financial woes. Medicaid expansion could keep their doors open and jobs intact.


Voters will go to the polls on November 21 to replace current governor and presidential candidate Bobby Jindal. Jindal was one of the first governors to oppose Medicaid expansion, but his departure may welcome a different take on the Obamacare provision.

Polls find Democratic state Rep. John Bel Edwards considerably ahead of his Republican opponent, Sen. David Vitter, in the gubernatorial race. And if he’s elected, Edwards said he’ll push for immediate Medicaid expansion. This expansion would cover and additional 300,000 Louisiana residents who now fall into the coverage gap — making too much money to qualify for Medicaid but too little to buy private market insurance.

Sen. Vitter has also said he’d consider expansion — but it may not be as prioritized as Edward’s plan. And Vitter said the roll out must be done “on Louisiana terms, certainly not Barack Obama terms.”