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Life Health > Long-Term Care Planning

State Election Results May Change ACA Fight Math

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Results from the state elections held Tuesday in Maine, New Jersey and Virginia could add to the headwinds facing policymakers who want to repeal or block the Affordable Care Act.

The results could also nudge the U.S. Senate a little further to the left on Affordable Care Act battles.

(Related: Virginia Governor’s Race Reaches Past Candidates)

Here’s a state-by-state look at what happened, and what the election outcomes could mean.


In Maine, residents voted 59% to 41% in favor of “Question 2,” a ballot measure that calls for the state to apply for Affordable Care Act Medicaid expansion, according to a preliminary vote tally posted by the Bangor Daily News.

Maine is the first state to put a decision about taking Affordable Care Act Medicaid expansion money on a state ballot, and health law supporters across the country hailed the vote as a victory for Medicaid expansion.

In Maine, however, Paul LePage, a Republican who opposes the Affordable Care Act and the Affordable Care Act Medicaid expansion program, is still the government.

Democrats control the Maine House by a margin of 77 to 72, but Republicans still control the Maine Senate by a margin of 18 to 17.

LePage put out a statement noting that, in 2002, Maine set up state-organized Medicaid expansion program that failed because of lack of a dedicated funding source.

The 2002 Medicaid expansion program “created a $750 million debt to hospitals, resulted in massive budget shortfalls every year, did not reduce emergency room use, did not reduce the number of uninsured Mainers and took resources away from vulnerable residents,” LePage said in the statement.

Credit agencies have predicted that adopting the Affordable Care Act Medicaid expansion program “will be ruinous to Maine’s budget,” LePage said. (Image: Centers for Medicare and Medicaid Services)

(Image: Centers for Medicare and Medicaid Services)

LePage said his administration will not implement Affordable Care Act Medicaid expansion until lawmakers provide adequate funding for expansion. “I will not support increasing taxes on Maine families, raiding the rainy day fund or reducing services to our elderly or disabled” to fund expansion, LePage added.

Whether or not the ballot measure vote actually leads to Medicaid expansion in Maine, it could put wind in the sails of Sen. Susan Collins, R-Maine.

Republicans hold just 52 of the 100 seats in the U.S. Senate. Collins has been one of several Republican senators who have frequently resisted Republican Affordable Care Act change proposals that could change Medicaid funding levels. She did not take a public position on Maine Question 2, but she may see the vote as justification for continuing to question proposed changes in Medicaid funding.

The Maine results do not do much for the Affordable Care Act public exchange program. Maine candidates and policymakers have not appeared to be talking much about public exchange plan coverage or

New Jersey

In New Jersey, Philip Murphy, a Democrat, defeated Kim Guadagno, a Republican, by a margin of 56% to 42% in the race to succeed Republican Chris Christie as governor, according to preliminary results published by

New Jersey has already taken Affordable Care Act Medicaid expansion money, but it has not set up its own Affordable Care Act exchange.

Murphy, who helped run the global investment management division at Goldman Sachs from 2001 through 2003, said while he was campaigning that he wanted to stand up to Republican efforts to “repeal the ACA and gut Medicaid and Medicare.”

Murphy does not seem to have said whether he supports the Affordable Care Act public exchange program, or wants New Jersey to set up an exchange.

Opponents accused Murphy of supporting a shift to a government-run, “single-payer” health finance system. Murphy does not mention singe-payer health finance proposals on his campaign website.


In Virginia, which, at press time, was the only state covered here that had easy-to-find election results for Tuesday posted on the web, Ralph Northam, a Democrat, defeated Ed Gillespie, a Republican, by a margin of 54% to 45% in the race to succeed Terry McAuliffe, a Democrat, as governor.

Northam is a pediatric neurologist who earned a bachelor’s degree from the Virginia Military Institute, according to his biography. He later worked as a resident at Walter Reed Army Medical Center, served as chief neurological resident at Johns Hopkins, and, as an Army doctor, cared for soldiers wounded in Operation Desert Storm.

Republicans control the Virginia House of the Delegates and the Virginia Senate, but only by a narrow margin.

Like Murphy, Northam has expressed support for the Affordable Care Act and opposition to efforts to repeal the law.

Like Murphy, North seems to have avoided giving details about which parts of the Affordable Care Act he likes. On his campaign website, he doesn’t mention either the public exchange system or single-payer health care. After a gubernatorial debate in September, he told a reporter at that he does support creating an option for letting people buy into Medicare or Medicaid coverage.

Read Key GOP Senator Susan Collins Lays Out Her Demands for Tax Bill on ThinkAdvisor.

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