Scott Walker, standing by while people die.
Tarika Collins is 45 years old. She has heart disease and injuries from car accidents. After a heart attack, she was unable to return to work. She's $500,000 in debt and has resorted to internet fundraising drives to try to stay above water. She lives in Florida, in medical limbo, and has
one hope: that today's election sends a message to Florida's leadership about Medicaid expansion.
"It would get me in the system," Collins, of Clearwater, said. "I would be able to get some health care. For me, it would mean a longer lifespan."
"Mostly, the emotions I feel are scared," she said of her wait for the outcome of the race between Gov. Rick Scott, a Republican, and former Gov. Charlie Crist, a Democrat. "Scared that it could go either way. I'm scared I'm going to die before [Medicaid expansion] comes."
It's not very often that an election truly is a life or death matter. For some portion of the nearly five million people in the Medicaid gap, this one absolutely is.
At least six states have close gubernatorial elections featuring an incumbent Republican who has resisted expanding Medicaid—an option states were given by the Supreme Court in 2012. Avalere Health, a strategic advisory services firm, has estimated that in Florida, Georgia, Kansas, Maine, and Wisconsin, almost 2.3 million people have been left uninsured because of that resistance.
"As we looked at it, we came to the conclusion that this is a very important election for the future of Medicaid," said Dan Mendelson, founder and CEO of Avalere Health. "And these six gubernatorial elections are the best examples of that. There are a number of other states where if the balance shifts even subtly, the balance will shift toward Medicaid expansion."
In two of these states—Maine and Wisconsin—a Democratic governor can make the difference immediately. In Maine, Republican Gov. Paul LePage has vetoed Medicaid expansion five times. He has been the only obstacle. In Wisconsin, the governor has the power to accept the Medicaid expansion unilaterally, by executive order, and doesn't need the legislature. In the other states, the loss of the governorship could be enough of a political threat to shift some Republican lawmakers. As Kansas, state Rep. Jim Ward (D)—an expansion proponent—argues, "it changes the whole discussion from, 'We don't even talk about it,' to 'It is something we will be talking about every day, it is something we would be pushing every day.'"