November 6, 2019

What yesterday's elections mean for health care

Daily Briefing

    The results are pouring in for Tuesday's gubernatorial and legislative elections held in Kentucky, Mississippi, and Virginia—and they suggest Medicaid changes could be coming in some of those states.

    Related: Where the 2020 Democratic candidates stand on health policy

    Kentucky's likely governor-elect vows to rescind Medicaid work requirements

    In Kentucky, Attorney General (AG) Andy Beshear (D) on Tuesday declared victory over current Gov. Matt Bevin (R). As of Tuesday night, Beshear held a lead of 5,333 votes over Bevin, out of the more than 1.4 million votes that had been counted, according to the Associated Press. However, Bevin as of Wednesday morning had not conceded the race, which means there could be a recount.

    A victory for Beshear likely puts an end to Kentucky's Medicaid work requirements, as Beshear on Tuesday said, during his first week in office as Kentucky's governor, he would rescind the Medicaid waiver that grants the state permission to implement the work requirements.

    The Kentucky requirements, which currently are blocked by a federal court, were a centerpiece of Gov. Bevin's re-election campaign. Bevin's administration and other supporters of work requirements argue that they help Medicaid beneficiaries find employment and can help to improve beneficiaries' overall health and wellbeing by lifting them out of poverty.

    But others have argued that Medicaid work requirements impose barriers to coverage for low-income individuals and can cause coverage losses.

    Beshear—the son of former Kentucky Gov. Steve Beshear (D), who expanded the state's Medicaid program under the Affordable Care Act (ACA)—earlier this year said his "goal is to make sure every single Kentuckian has some form of [health] coverage, and that we lower the cost for every single Kentucky family."

    Medicaid expansion not likely in Mississippi

    Medicaid expansion was a key issue at stake in Mississippi's gubernatorial race Tuesday, and Mississippi voters elected Lt. Gov. Tate Reeves (R), who has said he opposes Medicaid expansion "on philosophical grounds," to serve as the state's governor. Reeves defeated Mississippi AG Jim Hood (D), who had said he would expand the state's Medicaid program if elected.

    Mississippi is one of the 14 remaining states that have not expanded their Medicaid programs under the ACA. Mississippi has one of the highest uninsured rates in the country, as well as the lowest median household income. As such, expanding the state's Medicaid program under the ACA could provide many state residents with health coverage and bring a large sum of federal funding to the state.

    Medicaid eligibility and other coverage could expand in Virginia

    In Virginia, Democrats on Tuesday won enough seats to take control of Virginia's Legislature for the first time in more than 20 years, and are expected to try to lift certain restrictions on Medicaid eligibility in the state, the AP reports.

    Virginia Gov. Ralph Northam (D) expanded the state's Medicaid program in 2017, but the expansion includes some eligibility limits that were needed to get the plan approved by the state's Republican-controlled Legislature. However, with Democrats taking control of Virginia's Legislature, it is possible that state policymakers could look to lift the eligibility limits and possibly experiment with other types of health coverage expansions (Owens, "Vitals," Axios, 11/6; Sonka, Louisville Courier Journal, 11/6; Japsen, Forbes, 11/5; Hellmann, The Hill, 11/5; Schreiner, Associated Press, 11/6; Wagster Pettus, Associated Press, 11/6; Suderman, Associated Press, 11/6).

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