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Electoral Outcomes Mean Status Quo on Medicaid Expansion

By Rebecca Adams, CQ HealthBeat Associate Editor

November 5, 2014 -- The Medicaid expansion won't gain momentum from the outcome of the recent midterm elections. None of the gubernatorial candidates in key states who would have shifted policy to support a broadening of Medicaid eligibility won.

The state watched most closely was Maine, where GOP Gov. Paul LePage was the projected winner. LePage led with 48 percent of the vote against Democratic Rep. Michael Michaud, who got 44 percent by Wednesday afternoon, with 85 percent of the vote in. Eliot Cutler had complicated the race by running as an independent. The Maine legislature has passed a Medicaid expansion five times, but LePage vetoed each of those bills.

The race was tighter in Florida, where former Gov. Charlie Crist, running as a Democrat, lost 47 percent to 48 percent against incumbent GOP Gov. Rick Scott, with 98 percent of the vote in. Even if Crist had won, he would have faced a difficult challenge in getting the Florida House to accept an expansion. Crist had suggested he would try to take executive action to expand Medicaid, but experts in the state said it would have been a risk because he doesn't have clear authority to do so.

The legislature's opposition to an expansion would have been a problem in other states, including Kansas, Wisconsin and Georgia. Republican incumbents who have not embraced expansion won re-election.

On health-related state ballot initiatives that had received attention, Arizona voters passed a measure that would let drug companies give terminally ill patients treatments that the Food and Drug Administration has not approved.

Two other insurance-related measures in California did not pass. Proposition 45 would have given the state insurance commissioner the right to reject insurers' proposed rate increases. Proposition 46 included a long list of changes backed by consumer advocates, including an increase in medical malpractice awards and a requirement that physicians be tested for drug and alcohol use.

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