Issue key in GOP states

Candidates finding constituents support growing the program

LINCOLN, NEB.» For nearly a decade, opposition to former President Barack Obama’s health care law has been a winning message for Nebraska Republicans.

It’s helped them win every statewide office, control the Legislature and hold all the state’s congressional seats. So it was something of a surprise for Bob Tatum when he set out to ask his fellow Nebraskans if they would back a ballot initiative to expand Medicaid, one of the pillars of Obama’s health overhaul.

“There seems to be a lot more support than I anticipated,” said Tatum, who lives in a remote town near the Colorado border.

It took him little more than a week to gather more than 100 petition signatures in Perkins County, where roughly 70 percent of the 1,963 registered voters are Republicans. Tatum, 66, also is a Republican but differs from most of his party’s elected officials. He

supports the Medicaid expansion because his job as an ambulance driver brings him into frequent contact with working people who can’t afford insurance but earn too much to qualify for regular Medicaid.

“When I was circulating petitions, pretty much everyone signed it without objection,” Tatum said. “I didn’t expect that to be the case in rural Nebraska.”

Nebraska isn’t the only conservative state where residents are bypassing a legislature that has refused to expand Medicaid.

Voters in two other Republicandominated states, Idaho and Utah, also will decide in November whether to expand the health insurance program to more lowerincome Americans. Another ballot initiative, in Montana, seeks to raise a tobacco tax to keep funding a Medicaid expansion that is set to expire.

It also has become a focal point in numerous governor’s races.

The electionyear push in conservativeleaning states for one of the main aspects of Obama’s health care law has surprised many Republican lawmakers after they spent years attacking it.

Most GOP lawmakers in Idaho staunchly opposed expansion efforts there and cast it as a welfare program that would deepen the state’s reliance on the federal government. Supporters responded by gathering more than 75,000 petition signatures — far exceeding the minimum threshold to qualify for the ballot.

Expansion advocates launched a petition drive in Utah after continued resistance from the Republicandominated Legislature. Utah lawmakers did expand coverage to about 6,000 of the state’s neediest residents last year and approved another expansion measure with work requirements, but the federal government hasn’t yet accepted that plan. Expansion advocates say it still leaves tens of thousands of people without insurance.

Other states have seen Medicaid expansion become a top issue in their governor’s race, with Democratic candidates forcing Republicans to defend their opposition.

In Tennessee, Democratic contender Karl Dean argues that the state already has lost out on $4 billion in federal money by refusing to participate.

“That money is being spent in other states,” Dean said in a recent debate. “We need to get our Medicaid dollars back here.”

His Republican opponent, Bill Lee, noted Tennessee expanded its Medicaid program long before Obama was in office, but rolled it back in 2003 to balance the budget.

“We expanded Medicaid before, and it ended up failing and it almost broke the state,” he said.