Health care was rated one of the key issues for voters in the 2018 midterm elections, according to exit polls. The election results set the stage for as many as 500 000 low-income individuals in the United States to gain coverage through new state Medicaid expansions under the Affordable Care Act (ACA). Expansion could occur in 5 additional states: 3 through ballot measures (Idaho, Nebraska, and Utah) and 2 through the election of new governors supportive of expansion (Kansas and Maine). If all 5 states expand Medicaid, this will bring the number of expansion states to 37 (plus Washington, DC), with a potential increase in Medicaid enrollees from approximately 50 million in 2010 prior to enactment of the ACA to a projected 76 million by 2020 (Figure and eFigure in the Supplement). The election also brings some short-term legislative certainty for the ACA, as the new Democratic majority in the House of Representatives will forestall further attempts to repeal the law for at least 2 years. In this Viewpoint, we provide a postelection update on the status of the Medicaid expansion and recent research on the ongoing effects of the law.
Identify all potential conflicts of interest that might be relevant to your comment.
Conflicts of interest comprise financial interests, activities, and relationships within the past 3 years including but not limited to employment, affiliation, grants or funding, consultancies, honoraria or payment, speaker's bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued.
Err on the side of full disclosure.
If you have no conflicts of interest, check "No potential conflicts of interest" in the box below. The information will be posted with your response.
Not all submitted comments are published. Please see our commenting policy for details.
Goldman AL, Sommers BD. Medicaid Expansion Gains Momentum: Postelection Prospects and Potential Implications. JAMA. 2019;321(3):241–242. doi:10.1001/jama.2018.20484
Coronavirus Resource Center
Customize your JAMA Network experience by selecting one or more topics from the list below.