GOP State Election Victories Dim Chances For Medicaid Expansion

Republicans' big election gains Tuesday in governorships and legislatures around the country diminish but do not eliminate the prospects that more states will expand Medicaid to low-income adults as allowed by the healthcare reform law, political analysts say.

Republicans picked up governorships in at least three additional states, giving them at least 31 governorships and full party control of state government in at least 23 states. They even snared the governor's mansion in Democratic-leaning states like Illinois, Maryland and Massachusetts. GOP incumbents held their seats in all strongly contested races except in Pennsylvania. The fate of Alaska's gubernatorial race remains up in the air as absentee votes are counted, but for now an independent candidate who favors Medicaid expansion leads the race.

The GOP takeover of Congress may not dissuade Republican governors who already were considering expansion but it could slow them down, said Ford O'Connell, a Republican strategist who worked on Sen. John McCain's presidential campaign in 2008. That's because they know congressional Republicans may try to repeal Obamacare taxes that help fund Medicaid expansion, such as the medical-device tax. Such revenue losses could make conservative warnings come true that the federal government will not be able to live up to its promise of paying 100% for the Medicaid expansion through 2016 and paying 90% thereafter, he added.

Read more from Virgil Dickson at Modern Healthcare

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Analysis & Political Strategy