Medicaid-Expansion fights against hospitals, work against conservative groups and tobacco companies

While 33 states and the District of Columbia have extended Medicaid under the ACA, 17 states have refused to do so. The November 6 vote vote could affect expansion efforts in Kansas, Florida and other states that have not developed, the two sides said.

Supporters of the proposals spend less, except in Montana, where the Medicaid expansion would be funded by a tax on cigarettes and related products.

The tobacco industry has raised more than $ 12 million and spent more than $ 8 million to block Montana's initiative. According to election campaign forms, Montanans Against Tax Hikes, an anti-expansion political action committee, received most of its loans and contributions from Philip Morris' parent company.

The campaign for the measure, Healthy Montana for I-185, has spent more than $ 3.3 million, the bulk of its contributions coming from a group related to the Montana Hospital Association.

Medicaid traditionally covers pregnant women, children, the elderly and low-income families, and this extension expands this field to include low-income adults. Under ACA, the federal government will assume 93% of the cost of hedging new entrants in 2019, bringing it back to 90% in 2020 and beyond.

Proponents of expansion say states are rejecting millions of dollars in federal funding that could help low-income residents get health care.

Opponents say that many states can not afford an expansion and that Medicaid was designed solely to help those most in need. "It makes perfect sense to cover the most vulnerable and put scarce resources on it," said David Barnes, policy officer at Americans for Prosperity, a non-profit group initiated by conservative activists Charles and David Koch.

Polls indicate strong support for voting measures up to now. Fifty-nine percent of Utah's voters support this expansion, according to a poll by the Salt Lake Tribune-Hinckley Institute of Politics.

In Idaho, a political action committee called Work, Not Obamacare raised nearly $ 30,000 and spent about $ 10,000 to oppose the state's electoral initiative, according to campaign documents. A libertarian think tank, the Idaho Freedom Foundation, is a major donor.

This expense, however, is overwhelmed by proponents of expansion.

Idahoans for Healthcare had raised more than $ 500,000 and spent about $ 260,000 until September 3rd. He received nearly $ 550,000 in start-up funding from The Fairness Project, a group with strong support for manpower. Reclaim Idaho has spent nearly $ 79,000, according to the disclosure forms. Their major donors include the Idaho Academy of Family Physicians, the Idaho Medical Association and the Idaho Hospital Association.

In Utah, a group called No On Proposition 3 has been created but has not yet produced a campaign report. It is part of the Utah chapter of Americans for Prosperity. "We are making thousands of phone calls and using volunteers," said Heather Williamson, Local Director.

The expansion of Medicaid would result in an increase in state spending, Ms. Williamson said. "If the registrations exceed the estimates, we will have to pay the bill," she said.

In support of this measure, Utah Decides Healthcare has spent approximately $ 3 million. Most of this comes from The Fairness Project, which spent about $ 5.5 million to incubate and lead the expansion efforts in the four states, as well as in Maine. Their core funding comes from SEIU United Healthcare Workers West, a California-based health care union, as well as online donor and foundation support.

The equity project is also the largest donor to Insure the Good Life, the political action committee that is supporting the Nebraska expansion, which brought in about $ 1.7 million. Most of it has also been spent. A senator and a former senator, both Republicans, filed a lawsuit for the withdrawal of the initiative.

Montana extended its Medicaid program in 2015 as a pilot project, and the voting measure would extend it beyond 2019, by which time the extension is scheduled for completion. If the initiative succeeds, the state's cigarette tax would increase by $ 2 per pack.

"The Montanans against tax hikes are campaigning aggressively for voters to understand why they should reject I-185," group spokesman Sam Loveridge said, using the official name of the initiative. The group said the initiative would leave taxpayers on the hot seat and lock in a costly government program.

The group filed a lawsuit to change the wording of the ballot, which it said was prejudicial, but the state Supreme Court in August rejected the claim.

Proponents of the initiatives see the opposition of tobacco as a sign of honor.

"It sounds like David versus Goliath – if Goliath was also giving cancer," said Jonathan Schleifer, executive director of The Fairness Project, which supports voting measures.

Altria
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The parent company of Philip Morris USA and TMA, a professional group in the industry, did not return messages asking for comment.

Write to Stephanie Armor at [email protected]