The American Cancer Society’s advocacy arm is launching a $4.5 million campaign that aims to break GOP resistance to Medicaid expansion in several states debating whether to join the program.
The initiative launching Tuesday — which the group detailed exclusively to POLITICO and is its largest-ever education campaign — comes amid Democrats’ reinvigorated push for coverage expansion after health care-fueled 2018 midterm victories. The campaign will largely focus on Alabama, Georgia, Kansas and North Carolina, where 1.2 million low-income people could gain coverage if state leaders expanded Medicaid under the Affordable Care Act.
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Democratic governors in Kansas and North Carolina pushing expansion have faced resistance from Republican lawmakers, and GOP policymakers in Alabama and Georgia have cautiously considered conservative forms of Medicaid expansion. All 14 states that have not expanded Medicaid, including the four holdout states targeted by the cancer group’s campaign, have GOP-controlled legislatures.
“We really felt like our added resources could really help,” said Carter Steger, vice president of state and local campaigns for the American Cancer Society Cancer Action Network. “It certainly helps that people are listening and are thinking about Medicaid in these states. We picked these states because we thought there might be some opportunity.”
The campaign, titled “Medicaid Covers US,” will emphasize how Medicaid — a program that now covers about 75 million Americans — helps enrollees as well as communities. The organization will release a documentary Tuesday about uninsured Kansans with health challenges, in addition to a new website with individual stories and polling data finding widespread national support for Medicaid. It plans to release two more documentaries in the coming months.
The campaign will also highlight the experience of Medicaid expansion in Louisiana and Virginia, two Democratic-led states that adopted the program within the past three years.
Opposition to Medicaid expansion continues to run deep in some state legislatures, five years after states first could join the optional Obamacare program. Some Republican policymakers, however, are reconsidering their opposition, with an eye on the 2020 presidential election. They say there may be limited time to pass Medicaid expansion with conservative ideas like work requirements that a Democratic administration is unlikely to approve.
In Georgia, new Republican Gov. Brian Kemp, who campaigned against the Obamacare expansion, recently signed into law a bill that allows him to expand Medicaid to individuals below the federal poverty line — a move that could insure approximately 240,000 low-income Georgians. However, that’s short of Obamacare’s full expansion, which extends eligibility to adults earning 138 percent of the federal poverty level, or about $17,200 for an individual.
In Alabama, the state hospital association has long pushed expansion. Some Republican lawmakers have recently cracked open the door, although the state is not expected to embrace the program soon.
Some Democratic governors who campaigned on Medicaid expansion in conservative states, meanwhile, have struggled to win over enough Republican lawmakers.
In North Carolina, Gov. Roy Cooper has faced opposition from Republicans since his term started in 2017. Kansas Gov. Laura Kelly has made Medicaid expansion a major issue during her first months in office, but a bill has stalled in the state Senate after passing the House a month ago.
“Expanding on a failed system that has become too expensive for most Americans is not the answer,” state Senate President Susan Wagle, who may join the 2020 race to succeed retiring U.S. Sen. Pat Roberts, said earlier this month.
The ACS CAN campaign is mostly funded by a grant from the Robert Wood Johnson Foundation, though the cancer group paid for the polling and may fund additional activities in the future.
The campaign comes as advocates are trying to get Medicaid expansion on the ballot next year in Florida, Missouri and Oklahoma. ACS CAN said the possibility of ballot initiatives didn’t factor into its decision about which states to target.