Medicaid expansion in Utah finds grass-roots support

OGDEN, Utah — In this conservative state, which has not supported a Democratic presidential candidate in more than a half-century, a grass-roots campaign to expand Medicaid is building considerable momentum as Election Day approaches.

If it wins approval here, it could happen almost anywhere.

On Nov. 6, Utah voters will consider a ballot measure that would expand Medicaid to cover up to 150,000 more people under the Affordable Care Act. Two other conservative states, Idaho and Nebraska, will also vote that day on Medicaid expansion proposals.

The states, if the measures pass, would join more than 30 others that have expanded Medicaid under the 2010 health care law. In all three states, advocates are trying to outflank Republican lawmakers who have blocked expansion efforts.

The Utah push is five years in the making. State politicians and advocates have tried repeatedly, by one means or another, to expand Medicaid. Gov. Gary R. Herbert, a Republican, and his team have spent countless hours in negotiations with the Obama and Trump administrations. In 2015, the state Senate passed a bill, but it never reached the floor of the state House of Representatives.

Now, supporters of expansion are cautiously optimistic. Opinion polls suggest that 60 percent of Utah adults favor it. Advocates are energetic and well organized, knocking on doors and speaking frequently at public events. Opponents are lying low, but plan to make their case more forcefully before Election Day.

On a recent Sunday, a big blue banner hung inside First United Methodist Church here in Ogden, urging people to