Gubernatorial races to affect Medicaid expansion, insurance exchanges

While next month's presidential election will surely impact the future of health reform, state gubernatorial races also will shape the future of Medicaid and health insurance exchanges, reported CQ HealthBeat.

Several states already vowed to reject Medicaid expansion, and 13 other states committed to health reform. But most states are still undecided on the measure, FierceHealthcare previously reported.

Most polls indicate Republicans will likely expand their state governorships, with as many as 34 Republican states after the election. There are currently 29 Republican governors. But three of the state governor races are too close to call--Montana, New Hampshire and Washington--and their outcome could dramatically affect insurers' operations.

In New Hampshire, Democratic candidate Maggie Hassan has pledged to expand Medicaid, but her Republican opponent Ovide Lamontagne would not. But both candidates have said they're open to creating a state-run exchange but are worried about time constraints.

Montana, meanwhile, wouldn't expand Medicaid under a Republican governorship led by Rick Hill, who says an expansion could threaten the state's solvency while increasing health costs. But it's less clear what would happen if Democratic candidate Steve Bullock wins. He seems to be avoiding media questions about whether he supports health reform and his campaign materials don't indicate a leaning in either direction.

Washington's governor race is between Democrat Jay Inslee and Republican Rob McKenna. Inslee believes expanding Medicaid would help more people gain insurance coverage. He also would operate a state-run exchange. McKenna, however, opposes the reform law and joined the lawsuit challenging it. He says states eventually will pay for Medicaid expansion and would rather move Medicaid enrollees and uninsureds into private insurance, including consumer-directed health plans.

To learn more:
- read the CQ HealthBeat article

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