Few states have expanded Medicaid eligibility under the Affordable Care Act (ACA) since 2016, but a new trend may accelerate the pace of adoption. Last year, voters in Maine used their state’s citizen-initiated ballot referendum process to pass Medicaid expansion, and this November, four states will follow Maine’s lead. On Friday, Nebraska’s Secretary of State certified that supporters had collected enough signatures to put the question of Medicaid expansion to voters on Election Day. Nebraska joins Idaho and Utah, both of which will have Medicaid expansion on their November ballots. And late last month, the Secretary of State in Montana announced that an initiative that would permanently reauthorize the state’s Medicaid expansion, which took effect in January 2016 but is scheduled to sunset in 2019, had qualified for the ballot there.
