Idaho voters approve Medicaid expansion

November 7, 2018 GMT
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A sample ballot is seen in Idaho Falls, Idaho on election day Tuesday, Nov. 6, 2018. (John Roark/The Post-Register via AP) (John Roark/The Post-Register via AP)
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A sample ballot is seen in Idaho Falls, Idaho on election day Tuesday, Nov. 6, 2018. (John Roark/The Post-Register via AP) (John Roark/The Post-Register via AP)

BOISE, Idaho (AP) — Idaho voters approved the expansion of Medicaid coverage to potentially more than 60,000 low-income adults across the state, but rejected another initiative that would have legalized historical horse racing machines at Idaho race tracks.

The Medicaid expansion, or Proposition 2, will cover those who earned too much to qualify for Medicaid under Idaho’s current criteria, but didn’t earn enough to be able to get subsidized health insurance coverage under the state health insurance exchange. Dubbed Idaho’s “gap population,” they were often left with no way to access basic medical treatment, instead relying on expensive emergency room visits as untreated health problems became health crises.


Groups such as the American Cancer Society Cancer Action Network celebrated the passing of Proposition 2, saying it would allow more Idaho residents to access basic preventative care like cancer screenings.

“In fact, the biggest determining factor whether someone survives after a cancer diagnosis is whether they have health insurance,” Luke Cavener with ACS CAN wrote in a prepared statement. “With the passage of Proposition 2, we take a big leap in the fight against this devastating disease.”

The Medicaid expansion citizen initiative took shape after Idaho lawmakers for years refused to expand Medicaid or take other steps to significantly increase access to health care.

Opponents — including many lawmakers elected on Tuesday like Russ Fulcher, who will represent Idaho’s 1st Congressional District, and Janice McGeachin, who will be the state’s first female lieutenant governor — have said that expanding Medicaid coverage would force the state to pull money from other needs like education and infrastructure. Opponents have also argued that allowing able-bodied low-income adults to access Medicaid would serve as a financial shortcut for some rather than expecting them to come up with ways to cover their own healthcare costs.

But proponents of Medicaid expansion say the move will ultimately drive down state health care costs by reducing the costs of indigent care borne by local governments and health care facilities. The expansion will be primarily covered by federal tax dollars, although the state will have to kick in a portion of funding.

Still, proponents say the state would also save money because it would allow working low-income Idahoans to be healthier, able to contribute to the economy and care for their families.


Proposition 1 was also a contentious campaign, with proponents of the “historical horse racing terminals” saying they would bring badly needed revenue to Idaho’s struggling horse racing industry. The slot-like betting machines allow gamblers to watch a video of a historical horse race — with all identifying information removed — and bet on the winners. Players can also choose to ignore the race video and instead let the machine make automatic bets, watching a display of traditional slot-machine images such as diamonds, cherries or other symbols to learn if they won.

Lawmakers first approved the instant horse racing machines in 2013 but repealed the law two years later over concerns that they looked too much like casino-style machines. That’s when proponents of horse racing and the instant racing terminals launched the effort to bring them back through the ballot initiative.

Opponents criticized the effort as disingenuous, saying the state shouldn’t give special exemptions to gambling rules to prop up struggling private businesses.

Ken Andrus and Ernie Stensgar, both with Idaho United Against Prop 1, said in a joint prepared statement early Wednesday morning that the vote showed the initiative was “a bad bet for Idahoans.”