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Put Medicaid On The Ballot. It’ll Win.

Last week, Maine became the first state in the country to expand Medicaid by ballot initiative. By a nearly 20-point margin, quintessentially-purple-state Maine voted overwhelmingly to extend healthcare coverage to up to 89,000 low-income people. It’s more proof that Americans think healthcare should be a right, not a privilege for the wealthy — and it’s a model for progressives who want to make that dream a reality.

Here’s a quick refresher: The Affordable Care Act (aka Obamacare) authorizes states to expand Medicaid to everyone making up to 138 percent of the federal poverty level — $36,347 for a family of three and $15,417 for an individual. Thanks to the expansion, more than 14.5 million people enrolled in Medicaid by 2015. That’s 14.5 million more people who won’t have to choose between going to the ER and going bankrupt, who’ll be able to get preventative care and diagnose cancer while it’s treatable, whose lives may be saved by the ACA. Medicaid expansion is a resounding success, but 18 states — all run by Republicans — have still refused to do it. It turns out some Republican politicians are willing to deny tens of thousands of their own constituents potentially lifesaving healthcare for basically no reason but spite.

That’s exactly what was going on in Maine. Maine’s legislature passed bills to expand Medicaid five times — only to be vetoed every time by far-right Governor Paul LePage, a Trump-style culture warrior otherwise best known for blaming the state’s opioid epidemic on “guys with the name D-Money, Smoothie, Shifty” and challenging a State Rep to a duel over voice mail.

This year, Maine residents took politics into their own hands and put Medicaid expansion on the ballot, letting voters decide for themselves. It was a rout. Maine voted 60-40 to expand government-run healthcare to working-class people.

Turns out so-called socialized medicine is pretty popular after all.

According to an independent state agency, 89,000 Maine residents stand to gain coverage. Maine was the first state where activists put Medicaid on the ballot, and it won big. Let’s do it everywhere.

Let’s put Medicaid expansion on the ballot in Kansas, where 150,000 would gain coverage and where Obamacare hater and Governor Sam Brownback vetoed bipartisan legislation to expand the program in April. 

Let’s put Medicaid expansion on the ballot in Utah, where voters could guarantee access to healthcare to 46,000 people as soon 2018.

Let’s put Medicaid expansion on the ballot in Missouri (87,000 people would gain coverage), Idaho (78,000), Oklahoma (84,000), Wyoming (6,000), and Nebraska (16,000).

Let’s make every person running for the House tell us whether they’ll vote to expand Medicaid, or vote for their constituents to struggle under skyrocketing premiums. Let’s grill every candidate for Governor about whether they’ll faithfully implement the expansion, or if they’ll try to (illegally) sabotage it the way Trump is sabotaging the ACA.

Running on Medicaid expansion can help progressives prove to voters that Republicans are only looking out for the top one percent — and help us win back seats in the age that brought us Trump.

But far more importantly, Medicaid is a lifeline (literally) for low-income families. One landmark study found that, compared to similarly situated people without insurance, people on Medicaid were 40 percent less likely to have suffered a decline in their health over a six month period, more likely to be diagnosed and treated for depression and diabetes, and way more likely to get preventative care. Women with Medicaid were 60 percent more likely to get a mammogram than women without insurance.

Medicaid ballot initiatives are an end-run around Republican obstructionism, and they will save lives.

Header image via Mother Jones

Sejal Singh is a columnist at Feministing, where she writes about educational equity, labor, and reproductive justice. Sejal is a Policy and Advocacy Coordinator for Know Your IX, a national campaign to end gender-based violence in schools, where she has led several state and federal campaigns for student survivors' civil rights. In the past, Sejal led LGBT rights campaigns for the Center for American Progress. Today, she is a student at Harvard Law School and a frequent speaker on LGBTQ rights and civil rights in schools.

Sejal Singh is a law student and columnist at Feministing, writing about educational equity, labor, and reproductive justice.

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