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2018 midterm election results: Obamacare, healthcare big winner



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  • With Democrats’ victory in the House, Obamacare repeal is
  • Democrats hold a strong advantage on healthcare and Obamacare
    looks stronger than ever.
  • Three deep-red states expanded Medicaid, a key part of
    Obamacare, via ballot initiatives.
  • Other states where Democrats won the governors’ mansions
    could also undertake expansion.

Just two years after the future of the law was seriously in
doubt, the results of Tuesday night’s midterm elections
solidified Obamacare’s standing as the law of the land and showed
that many aspects of the landmark healthcare law are getting more

Democrats ran hard on the preservation of key aspects of the
Affordable Care Act, a choice that many in the party credit for
their House victory. A handful of states also voted to expand
their Medicaid programs under Obamacare.

Democrats won the messaging fight on healthcare

With Democrats regaining control of the House, the GOP push to
repeal and replace Obamacare is buried for the time being. If you
ask Democrats, the prospect of another shot at repeal helped
propel the party to victory.

Democratic Leader Nancy Pelosi, widely assumed to be the next
speaker of the House, pointed directly to healthcare as the key
to the party’s path to the majority.

It’s about stopping the GOP and Mitch McConnell’s assault
on Medicare, Medicaid, affordable health care, and millions of
Americans living with pre-existing medical conditions,”
Pelosi said during a victory speech
, referring to the Senate
majority leader.

The ACA is polling near its highest level ever. And many of the
law’s provisions, including protections for people with
preexisting conditions, remain significantly popular. The rising
popularity and the GOP’s legislative attacks on Obamacare allowed
Democrats to draw a stark contrast with their Republican

Healthcare ranked as
the top issue for voters in exit polling,
and Americans
generally trusted Democrats more than Republicans.
According to an exit poll
of 75 competitive, GOP-held
districts by the left-leaning Public Policy Polling, 52% of
people said they trusted Democrats more on healthcare, compared
to just 44% who trusted the GOP more.

The switch represents a huge change from the 2010 and 2014
midterms, when
Republicans hammered Democrats
on the ACA and healthcare in

An outstanding question, however, is what exactly Congress could
do to shore up Obamacare in a divided Congress. A bipartisan push
to reinforce the law’s individual insurance markets fell through
in 2017, but McConnell hinted that another deal could be on the
docket in 2019.

“We are going to have to try to address that on a
bipartisan basis,” McConnell said.

Medicaid expansion is a winner

Perhaps most significant for Obamacare’s legacy is the continued
popularity of the law’s Medicaid expansion. The ACA allows states
to expand Medicaid eligibility to people making up to 138% of the
federal poverty limit, helping low-income Americans gain access
to healthcare.

Expansion is heavily subsidized by the federal government to ease
the cost burden on states, but many state-level Republicans have
rejected the idea due to budgetary concerns. But slowly, the
protestations of the GOP are giving way to a gradual march of
Medicaid expansion.

Three deep-red states —
, and
— joined the 32 expansion states via ballot initiatives
on Tuesday. Solid majorities in each state voted for expansion,
which will help roughly 325,000 people gain access to

In addition to the direct pick ups for expansion, a couple of
governor’s races could lead to additional gains:

  • The Kansas legislature passed a bill to expand Medicaid in
    2017, but it was blocked by then-Gov. Sam Brownback.
    Pro-expansion Democrat Laura Kelly took the governor’s mansion,
    which could allow another crack at expansion and open to door for
    150,000 more people
    to enroll in Medicaid.
  • Tony Evers, the Democratic
    governor-elect in Wisconsin
    could also accept federal aid to boost the state’s Medicaid
    program and extend
    to another 176,000 people
    the state.
  • Additionally, Maine Gov. Paul LePage’s refusal to implement
    Medicaid expansion despite a 2017 vote in favor of the move will
    likely be broken by the new Democratic Governor-elect Janet
    70,000 people in the state
    could be eligible for Medicaid if expansion
    moves forward.

Other states could see expansion, like in North Carolina, where
Republicans lost their supermajority in the state legislature,
but that remains less likely.

In total, with the ballot initiatives and governors’ races, up to
721,000 Americans could gain access to healthcare via Medicaid
expansion in the wake of the midterms.

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