Healthcare has been a central theme of the 2018 election, arguably more so than any other election in recent history.
Between lobbying dollars spent on blocking a California ballot measure that would significantly impact dialysis companies to the president's tweets promising Republicans will protect pre-existing conditions, healthcare policy has been a near-constant talking point on both sides of the aisle.
Here's what the FierceHealthcare editorial team will be keeping our eyes on after the polls close later this evening:
- New doctors in Congress? The election could shake things up on Capitol Hill in more ways than one. There are four female doctors running for Congress as Democrats. And if one of them is elected, she will be the first Democratic female doctor in that legislative body. They are among a total of nine doctors who are seeking seats.
- Dialysis center revenue caps: There are a number of health-related measures being considered by California voters on Election Day, but the most contentious is Proposition 8. The ballot initiative would cap the amount of revenue that can be made by dialysis centers to 15% more than their costs of doing business. Opponents, largely backed by dialysis giants like Davita and Fresenius Medical Care, have spent a record $111 million in attempt to defeat the measure.
- Maine’s new governor: Current Maine Gov. Paul LePage has made a name for himself for the lengths he’s willing to go to prevent his state from expanding Medicaid, which was passed by residents in a ballot measure in 2017. A new governor could shift the tenor around that discussion or maintain the status quo. A recent poll had Democratic candidate Janet Mills up eight points on Republican contender Shawn Moody. Mills has vowed to implement expansion to 70,000 Mainers. Moody has historically sided with LePage on expansion but recently said he would implement the ballot measure with “sustainable and responsible funding.”
- Infrastructure funding for children's hospitals: Another big issue for California voters? Proposition 4, a bond measure meant to provide funding to support infrastructure upgrades at the state's pediatric hospitals. Specifically, the measure would authorize $1.5 billion in bonds to be repaid from the state's general fund for construction, expansion, renovation and equipping of children's hospitals. Proponents say it's an important investment in the facilities that serve the most vulnerable patients, while critics have called for accountability in the hospitals' spending.
- Nurse ratios in hospitals: In Massachusetts, residents will consider a ballot initiative that would set limits on the number of patients that can be assigned to a nurse. Proposed by the Massachusetts Nurses Association, the union says mandated limits will improve patient safety and prevent burnout among nurses. It has faced strong opposition from many of the state’s most notable medical groups, including the American Nurses Association Massachusetts, the Massachusetts Health & Hospital Association and the Massachusetts Medical Society.
- Idaho Medicaid expansion polling: Support is brewing for Medicaid expansion in Idaho even among the state’s Republican governor. Idaho is one of four states with some kind of expansion measure on the ballot, and it has a real chance of passing. Gov. Butch Otter recently offered a surprising endorsement of the initiative, even going so far as to call it the “right thing for Idaho” in a recent ad. An August poll, before Otter came out in support of the measure, showed 45% of residents supported expansion with 36% undecided. That’s on top of past polling that has shown significant support for expansion.
- In-home care: Maine voters will consider proposal to institute a universal home care program in the state, an initiative that would be the first of its kind in the U.S. Home healthcare costs an average of $50,000 a year in Maine and is not covered in full by Medicare, according (PDF) to the Maine People’s Alliance, one of the advocacy organizations backing the measure. In tandem, Maine’s population of seniors is set to double by 2030. The Universal In-Home Care program would be funded with a 3.8% tax on residents with gross wages over $128,400. This would raise an estimated $123 million for a trust fund covering the care, according to the alliance.
- Florida contentious governor race: The Florida governor race has gradually become a knock-down, drag-out fight between Democrat Andrew Gillum and Republican Ron DeSantis. As of Monday, one poll had the two candidates at a statistical tie, while another had Gillum at a seven-point lead. It’s one of the governor races that most of the country will be watching as well, in part because it will offer at least one clear referendum on President Trump. But it also has significant implications for healthcare. Gillum backs Medicaid expansion but would likely receive significant pushback from state legislators, setting up what would be a contentious battle in the early stages of his appointment.