Recently, support for Medicaid expansion has grown dramatically, years after the Affordable Care Act (ACA) put it into motion. This fact was on full display when Oklahoma expanded Medicaid by narrowly passing a ballot measure, which will, in 2021, make at least 200,000 low-income residents eligible for the program within the state.

The politics of Medicaid expansion has been a winning issue as of late despite efforts by the Trump administration to overturn the ACA.

Even in the face of this opposition, 38 states and DC have now adopted Medicaid expansion. This includes six states that have expanded Medicaid since President Trump assumed office (Idaho, Maine, Nebraska, Oklahoma, Utah, and Virginia) through a combination of ballot measures, executive orders, and legislation (Exhibit 1).

Looking ahead, Missouri will be the next state to vote on Medicaid expansion through Amendment 2 on August 4, and the issue will be a top campaign issue in the fall, especially in states like North Carolina, where expansion efforts are politically deadlocked.

As voters prioritize the issue — evidenced by Oklahoma’s recent success — a new poll from the Kaiser Family Foundation found 66 percent of voters in states that have not expanded Medicaid believe it should be.Even without the support of policymakers in some states, it seems voters will continue to make their views on the issue clear.

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