President Donald Trump and the Republicans took a beating in the November 2017 elections, and healthcare was at the forefront.

Democrats were euphoric about the Nov. 7, 2017, results, which included governors’ seats won in Virginia and New Jersey, as well as a win for Medicaid expansion in Maine.

Virginia was the crown jewel of the victories for Democrats, as Lt. Gov. Ralph Northam defeated Republican Ed Gillespie, a respected state politician who ended up embracing some of the more controversial tenets of Trump’s rhetoric near the end of the race.

Northam’s victory is an endorsement of current Gov. Terry McAuliffe, who has been an ardent supporter of Medicaid expansion and the Affordable Care Act since he took office in January 2014. McAuliffe’s effort to push Medicaid expansion through was continuously met with resistance by Republican lawmakers who controlled the state legislature. But Democrats also picked up at least 15 seats in Virginia’s House of Delegates, giving Northam an opportunity with Medicaid expansion that McAuliffe was not afforded.

Further encouraging the prospects for possible Medicaid expansion in Virginia and other states was a separate development election night: Maine voters approved a ballot measure to expand its Medicaid program. This action had been vetoed repeatedly by Republican Gov. Paul LePage, but voters forced it through with the referendum.

States like Utah and Idaho have reportedly formed Medicaid action committees and could follow Maine’s lead and push for ballot votes. Roughly 80,000 additional Maine residents will be eligible for Medicaid benefits because of pro-expansion efforts.

Virginia lawmakers will surely be discussing program expansion in 2018 with Northam, who is a veteran and physician, as governor and the state legislature leaning more Democratic. It’s been estimated an additional 400,000 Virginians could receive health insurance coverage via Medicaid expansion.

The election results are a sharp rebuke of Trump, who has made healthcare a major platform of his young presidency by attempting to repeal and replace the Affordable Care Act. Virginia voters showed their rejection of Trump policies by ranking healthcare as a top priority during exit interviews.

In New Jersey, Democrat Phil Murphy’s defeat of Republican Kim Guadagno signaled that residents there were ready to move on from Chris Christie and the GOP. New Jersey expanded Medicaid under Christie but did not form its own state health insurance exchange, another major feature of the Affordable Care Act. Christie was also a well-publicized backer of Trump during the presidential race.

So, Trump may very well plow ahead with his efforts to tear down the Affordable Care Act. Given his tendency not to admit failure no matter the circumstances, it’s a certainty he will. But election night 2017 showed that voters wield significant power and are willing to lead their states past the president’s platform in the name of their best interests, particularly when it comes to healthcare.

Chris Silva is a senior analyst at DRG and specializes in information technology, telehealth and big data, among other topics. Follow him on Twitter at @ChrisSilvaDRG


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