Lack of Medicaid Expansion in Inflation Reduction Act Means Ballot Measure Campaigns Remain Critical For Health Care Access

Washington, DC – This week, as Congress is working to finalize a sweeping tax, climate, and health care reconciliation package, chances appear slim that the final package will close the Medicaid coverage gap. As the Washington Post editorial board noted: “[T]he failure to close the Medicaid coverage gap means the most vulnerable will get the least help.”

When gridlock and polarization at the federal level have blocked popular legislation, ballot measures have repeatedly proven to be an effective path to expand Medicaid and ensure individuals and their families can get the care they need by taking matters into their own hands.

“While Congress and state legislatures have stalled on fixing the coverage gap for a decade, millions of Americans continue to be trapped without affordable health coverage —a tragedy unbefitting the wealthiest nation in the world. Voters can and should continue to make change themselves by passing Medicaid expansion through citizen-initiated ballot measures. That pathway has proven successful in six states, soon to be seven should South Dakota voters expand Medicaid this November,” said Kelly Hall, Executive Director of the Fairness Project.

In the 12 states that never expanded Medicaid under the Affordable Care Act, millions of  Americans make too much income to qualify for Medicaid but not enough to qualify for subsidies through the ACA marketplace. Although the Inflation Reduction Act would extend ACA subsidies put in place during the pandemic, the bill does not provide a solution for the millions of Americans still stuck in the coverage gap. 

The Fairness Project has helped to steer six statewide ballot measure campaigns to expand Medicaid, bringing health care coverage to 875,000 people. Currently, the Fairness Project is supporting the South Dakotans Decide Healthcare campaign, its seventh, which will be on the ballot this November. The South Dakota measure would expand health care for over 40,000 people and bring hundreds of millions of dollars back into South Dakota to create jobs and protect rural hospitals.