After months of political ads, campaign rallies, and claims and counterclaims, the 2018 midterm election is finally in the rearview mirror. Voters across the country have spoken, and when it comes to health care, they sent several loud and clear messages that their newly elected leaders would be smart to heed.
First and foremost, this was a health care election. Health care was the most frequently mentioned topic in gubernatorial and Congressional campaign ads in 45 local media markets, with more than 1.2 million ads mentioning health care. Regardless of political affiliation, people went to the ballot box with health care on their minds. Forty-one percent of national voters in exit polls identified health care as the single most important issue facing the nation, outpacing both immigration and the economy. The same poll found that 69% of voters believe that the American health care system needs major changes. Of that group, 55% identified as Democrats and 43% identified as Republicans, demonstrating a bipartisan consensus on the need for improvements.
Second, voters resoundingly supported Medicaid and the important role it plays in helping people get the health care that they need. By wide margins, voters in Utah, Idaho and Nebraska– three red states– voted to expand Medicaid, covering 363,000 people. Expansion states have seen benefits in improved health outcomes, affordability for individuals, stability for rural hospitals, and boosts to state economies and jobs, and people are showing they will demand action when their leaders don’t act on their own. In response to this clear mandate, officials in these states should move to quickly implement these expansions, without delays or creating additional bureaucracy or barriers to care.
In another endorsement of the importance of Medicaid, voters in Maine and Kansas elected new governors whose campaign promises included moving forward with Medicaid expansions that have stalled in their states. The voters of Ohio elected Mike DeWine as governor, who pledged his support for continuing the state’s successful Medicaid expansion, which covers 640,000 Ohioans.
Third, protecting people with pre-existing conditions is a new national consensus. Candidates from across the political spectrum emphasized their commitment to people with pre-existing conditions, often drawing on personal family stories. This may seem like a fait accompli, but it’s important to remember that as recently as 2013, shopping for insurance meant filling out a detailed health history to see what kind of coverage an insurance company would offer you – if any at all – and whether they would exclude the needed treatment for a child’s asthma, or a parent’s diabetes, and how much extra having a medical condition would cost in premiums each month. Opinions may differ on whether candidates accurately portrayed their voting histories as they pledged to protect people from these practices, but voters should hold leaders of both parties accountable for their promises to maintain these protections.
Finally, this election shows that people are ready to move past the highly politicized back and forth over the Affordable Care Act and onto new ideas to make health care work better for American families. Voters in several states elected governors who support creating a choice for people not otherwise eligible to purchase Medicaid coverage, as a way to increase choice, competition, and affordability. New Mexico Governor-elect Michelle Lujan Grisham made this proposal a centerpiece of her health care platform, and advocates in the state have been hard at work– in partnership with USofCare– exploring the best policy design options for the state to inform the expected debate in the state legislature next year. Minnesota Governor-elect Tim Walz has endorsed a similar proposal to allow people to purchase MinnesotaCare coverage, and Illinois Governor-elect J.B. Pritzker proposed a Medicaid buy-in program known as IllinoisCares.
Regardless of how they voted on Tuesday, when it comes to health care, the vast majority of Americans simply want to know they can get the care that they need, without undue hassle or financial hardship. Now that the election is over and the attack ads are off the airwaves, it is time for our newly elected leaders to step away from the campaign rhetoric, listen to their constituents and make real progress on addressing our country’s health care challenges.