The Charlotte Observer (Sunday) - - Front Page - BY NOAM N. LEVEY Los An­ge­les Times

Vic­to­ries bring to 36 the num­ber of states that have elected to ex­pand Med­ic­aid cov­er­age, and more could be on the way.

Ne­braska state Sen. Adam Mor­feld, like health care ad­vo­cates in many con­ser­va­tive states, was be­gin­ning to lose hope last year that his poor­est con­stituents would ever get health cov­er­age through the Af­ford­able Care Act.

“Af­ter seven years of los­ing in the Leg­is­la­ture, it was ap­par­ent that pass­ing Med­ic­aid ex­pan­sion just wasn’t po­lit­i­cally fea­si­ble here,” he re­called.

To­day, Mor­feld and ad­vo­cates in Idaho and Utah are cel­e­brat­ing the un­think­able: Vot­ers in these three deeply red states backed bal­lot mea­sures in this month’s elec­tion to ex­pand Med­ic­aid el­i­gi­bil­ity through the 2010 health care law, of­ten called Oba­macare.

The vic­to­ries – which bring to 36 the num­ber of states that have elected to ex­pand Med­ic­aid cov­er­age – were the prod­uct of a model of po­lit­i­cal ac­tion that may be­come in­creas­ingly com­mon across the coun­try in com­ing years, par­tic­u­larly in tra­di­tion­ally Re­pub­li­can states.

The model re­lies on state bal­lot mea­sures to cir­cum­vent state leg­is­la­tures and gov­er­nors’ of­fices dom­i­nated in many states by the most con­ser­va­tive wing of the GOP.

It taps into pop­u­lar sup­port for tra­di­tion­ally lib­eral ideas – such as ex­tend­ing health cov­er­age to the poor and rais­ing the min­i­mum wage.

And the model brings to­gether lo­cal ac­tivism with fund­ing and strate­gic guid­ance from a na­tional or­ga­ni­za­tion called the Fair­ness Pro­ject, a non­profit ad­vo­cacy group founded three years ago by a Cal­i­for­nia la­bor union.

“Bal­lot ini­tia­tives al­low us to put ques­tions of eco­nomic fair­ness di­rectly to the peo­ple,” said Dave Re­gan, pres­i­dent of SEIUUnited Health­care Work­ers West, who has called on or­ga­nized la­bor to sup­port broader po­lit­i­cal cam­paigns to sup­port work­ers, even if they are not union mem­bers. “We are show­ing that peo­ple in Utah and Idaho and Ne­braska want the same thing as peo­ple in Cal­i­for­nia.”

Since 2016, the Fair­ness Pro­ject has backed 17 cam­paigns across the coun­try, and won in 16.

In ad­di­tion to this year’s Med­ic­aid mea­sures, the pro­ject helped lead suc­cess­ful pas­sage in 2017 of a bal­lot ini­tia­tive to ex­pand Med­ic­aid in Maine.

It has backed suc­cess­ful min­i­mum wage cam­paigns in Ari­zona, Arkansas, Cal­i­for­nia, Colorado, Maine, Mis­souri, Wash­ing­ton, the District of Co­lum­bia and Mas­sachusetts. In Cal­i­for­nia and Mas­sachusetts, law­mak­ers acted fac­ing the prospect of a bal­lot cam­paign.

A suc­cess­ful 2018 mea­sure will re­strict pay­day lend­ing in Colorado. And ini­tia­tive cam­paigns or the threat of them have ex­panded paid fam­ily leave in Ari­zona, Michi­gan, Wash­ing­ton and the city of San An­to­nio.

The only set­back was in Mon­tana this year, where a flood of to­bacco in­dus­try money helped de­feat a mea­sure to ex­tend a Med­ic­aid ex­pan­sion set to sun­set in 2019.

In Ne­braska, Mor­feld first heard of the Fair­ness Pro­ject last year while read­ing news re­ports about the pas­sage of the Maine Med­ic­aid mea­sure. He im­me­di­ately emailed the group ask­ing for help.

Mor­feld and oth­ers in the state, in­clud­ing health care groups and the lib­eral ad­vo­cacy or­ga­ni­za­tion Ne­braska Ap­ple­seed, had been ar­gu­ing for years that ex­pand­ing Med­ic­aid would help work­ing fam­i­lies who couldn’t af­ford health cov­er­age.

The Af­ford­able Care Act makes hun­dreds of bil­lions of fed­eral dol­lars avail­able to states to ex­tend Med­ic­aid cov­er­age to poor adults, a pop­u­la­tion that had been largely ex­cluded. Med­ic­aid el­i­gi­bil­ity was his­tor­i­cally lim­ited to vul­ner­a­ble pop­u­la­tions, such as low-in­come chil­dren, preg­nant women, the el­derly and peo­ple with dis­abil­i­ties.

“I come from the per­spec­tive that peo­ple can work hard but still need as­sis­tance,” said Mor­feld, who was raised by a sin­gle mother who at times re­lied on govern­ment as­sis­tance to sup­port her fam­ily.

That mes­sage never res­onated in the state Capi­tol, where con­ser­va­tive state law­mak­ers and the gover­nor said Ne­braska couldn’t af­ford the ex­pan­sion and shouldn’t pro­vide

govern­ment cov­er­age for Ne­braskans who could work.

But when the Fair­ness Pro­ject came to Ne­braska shortly af­ter Mor­feld’s email and fielded a statewide poll, ad­vo­cates dis­cov­ered that state res­i­dents, in fact, were very sym­pa­thetic to the idea of help­ing their neigh­bors get cov­er­age.

It was the same in Idaho and Utah, where broad pub­lic sup­port for Med­ic­aid con­vinced ad­vo­cates that an ini­tia­tive cam­paign could work.

In Ne­braska, there was some prece­dent for this strat­egy. State vot­ers had backed a min­i­mum wage mea­sure in 2014.

But in Utah, bal­lot mea­sures had rarely been used, in part be­cause col­lect­ing enough sig­na­tures was ex­tremely ex­pen­sive. “It just wasn’t some­thing that was done,” said RyLee Cur­tis, cam­paign man­ager for Utah De­cides, that state’s Med­ic­aid cam­paign.

With fund­ing from the Fair­ness Pro­ject, how­ever, ad­vo­cates in Ne­braska, Idaho and Utah were able to fan out across their states and col­lect more than enough sig­na­tures.

They also honed a mes­sage that spot­lighted the work­ing peo­ple who would ben­e­fit, and they drew vot­ers’ at­ten­tion to the tax money the states were send­ing to Wash­ing­ton and not get­ting back.

That was par­tic­u­larly im­por­tant for vot­ers in the con­ser­va­tive states, said Maria Weeg, the gen­eral con­sul­tant to the Idaho cam­paign. “You have to root a cam­paign to the place where you are run­ning,” she ex­plained.

Equally im­por­tant, the three Med­ic­aid cam­paigns worked to en­sure that Med­ic­aid ex­pan­sion was not seen as a Demo­cratic Party is­sue.

That also proved crit­i­cal. Sur­veys by Fair­ness Pro­ject shortly be­fore Elec­tion Day showed solid sup­port for the mea­sures by Re­pub­li­can vot­ers.

In Ne­braska, GOP women sup­ported it by 13 points, ac­cord­ing to the polling.

At the same time, sup­port for the Med­ic­aid mea- sure did not mean that GOP vot­ers were will­ing to back Demo­cratic can­di­dates, as the GOP re­tained a strong hold on elected of­fices in all three states.

In the end, the three mea­sures passed com­fort­ably, with the Idaho ini­tia­tive get­ting nearly 61 per­cent and the mea­sures in Utah and Ne­braska mea­sure net­ting 53 per­cent.

To­day the Fair­ness Pro­ject is al­ready eye­ing pos­si­ble Med­ic­aid ex­pan­sion cam­paigns in other non­ex­pan­sion states that al­low bal­lot ini­tia­tives, in­clud­ing Flor­ida, Mis­sis­sippi, Mis­souri, Ok­la­homa, South Dakota andWy­oming.

“Our premise has been that peo­ple care more about the strug­gles of work­ing fam­i­lies than their politi­cians do,” said Jonathan Sch­leifer, head of the Fair­ness Pro­ject. “By us­ing bal­lot ini­tia­tives, we will con­tinue to cut politi­cians out of the pic­ture.”



Sup­port­ers of a Mon­tana bal­lot ini­tia­tive to ex­tend the state’s Med­ic­aid ex­pan­sion pro­gram and raise to­bacco taxes rally Nov. 5 in He­lena, Mon­tana.


Or­ga­niz­ers with Ida­hoans for Health­care drove this green truck around the state to sup­port Med­ic­aid ex­pan­sion.

Newspapers in English

Newspapers from USA

© PressReader. All rights reserved.