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Capstone partners llc portland write for me mime capstone design finger writing font ´╗┐name voters passed a referendum to expand Medicaid in Tuesday's election Sarah rice for the New York Times Washington the election results in Maine and Virginia have energized supporters of expanding Medicaid under the Affordable Care Act in several holdout states after months of battling Republican efforts to repeal the law they now see political consensus shifting in their direction groups in Idaho and Utah are already working through the process of getting Medicaid expansion initiatives on next year's ballots hoping to follow Maine's path after failing through the legislative route and the outlook for legislative approval has brightened in Virginia after Democrats picked up at least 15 seats in the republican-controlled House of Delegates and could potentially control the chamber once all the votes are counted advocacy groups are also hoping the decisive victory in Maine and exit polls suggesting health care was the top issue in Virginia will add momentum to efforts in Kansas and North Carolina the results from Maine and Virginia send a very clear signal that the public is interested in moving past the type of obstruction we've seen from policy makers in some states said Katherine Howard associate director of policy at community catalyst a consumer advocacy group the expansion debate in many states has been a political stew with opposition a mix of fiscal concerns philosophical resistance and stiff political opposition to Obamacare which made Medicaid expansion possible but many advocates hope growing public support for expansion and the fading of the Obama era will mean a softening of opposition amongst some governors and legislators who have long resisted the idea expanding Medicaid was a key provision of the Affordable Care Act meant to ensure that all Americans below a somewhat above the federal poverty line would qualify for government health insurance but a Supreme Court decision in 2012 made the choice to expand coverage optional for states before election day thirty-one states and the District of Columbia had chosen to accept federal funding to expand coverage in Virginia the outgoing Democratic terry mcauliffe tried repeatedly to expand Medicaid but the majority Republican legislature kept blocking it advocates their hope that Democratic gains in the legislature and perhaps some changes of heart among Republicans were read by the exit polls showing health care to be a top concern could mean enough votes to approve expansion in Maine legislators had voted to expand the program five times but gov paul LePage a Republican vetoed each bill though the outcome of the ballot initiative is not subject to a veto Mr LePage indicated in a statement Wednesday that his administration will not implement the change unless the legislature identifies funding sources for the state portion of the program's costs expansion supporters insisted the state had no choice but to expand Medicaid but acknowledged mr. LePage could make it difficult over the next year his last in office he could violate the law said Robin Merrill who helped run the pro expansion campaign but if the people who are now eligible for coverage or denied it they will have legal recourse not every state's voters can count on ballot initiatives as a means of expanding Medicaid fewer than half the states in the country allow citizen driven initiatives including some of the largest that have declined to expand like Texas and Georgia with the expansion Maine would join the 31 other purple states in the District of Columbia neither does Kansas where the Republican controlled legislature voted to expand Medicaid earlier this year but failed to override a veto by gov Sam Brownback mr. Brownback is awaiting confirmation to an ambassador at large position in the Trump administration but left tenant dub Jeff Colyer a fellow Republican who would replace him has also indicated he would resist expansion still david jordan who leads the alliance for a healthy can zhis an advocacy group pointed out that if mr. Collier becomes governor he will face reelection a year from now in a state where polls have found resupport for expanding Medicaid yesterday's results Virginia and Maine should send a message to him mr. Jordan said it could become really tough to go against this wave but for many Republican politicians the idea of expanding Medicaid remains hard to love providing government insurance coverage to poor adults who are not disabled is another matter many they view such help as discouraging work though data suggests most new Medicaid recipients have jobs and states that expanded did not see reductions in employment among low income people Seema Verma the administrator of the Centers for Medicare and Medicaid Services which oversees the program told state Medicaid directors on Tuesday that her department would begin approving state plans to condition Medicaid coverage for non-disabled adults on work of volunteer hours believing that community engagement requirements did not support a promote the objectives of Medicaid is a tragic example of the soft bigotry of low expectations consistently espoused by the prior administration most Verma said those days are over several states have asked Maas Verma's office for permission to impose work requirements on Medicaid beneficiaries mat solo the executive director of the National Association of Medicaid directors said that he thought work requirements might make expansion more acceptable to some state legislators like Florida's that have been reluctant in the past you can rebrand that he said you can do that very effectively the federal government paid the entire cost of expanding Medicaid for the first three years of Obamacare but that changed this year states now must pay five percent of the new beneficiaries medical bills a proportion that will increase to ten percent by 2020 so any state that expands now will need to find some funding to pay for its share states that expanded Medicaid expect to spend eight point five billion dollars from their own funds on expansion in the 2018 fiscal year according to the National Association of state budget offices every political decision is about value and the value is what's the return for the money said Tony Kaye a former director of South Carolina's Department of Health and humans services a state that has not expanded mr. Keck now a hospital executive said that legislators there thought it was more important to invest in existing populations of Medicaid beneficiaries than to expand the program to cover childless adults in Utah a newly formed political committee called Utah decides healthcare just concluded seven required public hearings around the state and hopes to soon start gathering the 113 thousand one hundred and forty three signatures needed to get an expansion question on next year's ballot the republican-controlled legislature could interfere if the initiative were to pass but Riley Curtis the campaign manager for the Utah our effort said she doubted him would because gov gary Herbert in the state Senate had tried to expand Medicaid in the past Jonathan Schleifer the executive director of the furnace project a left-leaning group founded in California that donated nearly seven hundred thousand dollars to the pro expansion campaign in Maine said the group was eager to help the efforts in Utah and Idaho and scout out other states where ballot initiatives might work grassroots groups in other states were waiting to see what happened last night and now they know what's possible said Mr Schleifer his voice hoarse from weeping at a victory party in Maine on Tuesday night in the next couple weeks well be able to start talking about what other states have the ability to run these initiatives and the grassroots enthusiasm to do that [Music] do my best internet of things mutual funds Cayuga Community College.

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