Does My Vote Affect Health Insurance? The 2018 Midterms Could Bring Change To These States

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If you’ve ever gone to the doctor with a case of what you thought was the flu, only to be sent home to sniffle alone after shelling out a couple hundred dollars, you’ve probably thought about health insurance. Whether you have insurance through your job, your parents, the state marketplaces established under Obamacare, or you're uninsured at the moment, it’s one of the first things that comes to mind when your throat starts to itch or your stomach feels queasy. So it’s natural to wonder if the midterms will affect your health insurance, for better or for worse.

Right now, insurance is regulated both by states and by the federal government. Those regulations are codified — written down and made official — by law. There are two ways for a bill to become a law, so there are basically two ways the midterms might affect your health insurance.

The first way a bill can become a law is through a congressional vote. If we’re talking about a federal law, that means we’re talking about the U.S. Congress — the House of Representatives and the Senate. If we’re talking about a state law, however, we’re talking about the chambers of your state legislature. In the midterms, you’ll vote for candidates who will fill all of those chambers.

Where are you going with this?

You’re voting for the people who are going to vote on laws that regulate health insurance. That means you get a say.

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If you think the government should regulate health insurance more than it already does, and you vote for a candidate who shares that opinion, then they’re pretty likely to try and pass laws to make it official. If you think the government regulates health insurance more than it should, casting your ballot for a candidate who wants to reduce government regulation is a pretty good way of making sure your position is represented.

Hmph. Wasn't there a second way?

There’s another way a bill can become law, but it’s only applicable to state laws, not federal laws. Ballot measures are proposed laws you get to vote on — and if enough people cast a “yes” vote, that measure becomes state law.

If your state has a ballot measure that addresses health insurance, then you get a direct say in whether or not that proposal becomes law. In January, voters in Oregon went to the polls for a special election specifically to vote on whether or not to approve taxes on hospitals and health insurance companies in order to help the state pay for low-income Oregonians’ health insurance. Voters passed the measure by a wide margin.

Do I get to vote on a health insurance measure this year?

If you want to find out what ballot measures you’ll be voting on in November, you can use a tool like the National Conference of State Legislatures’ ballot measures database. And here are just a few other states where voters will see health insurance measures on the ballot in November:

  • Utah Proposition 3 is a measure that would require the state of Utah to provide Medicaid for people who are under the age of 65 and have incomes equal to or below 138 percent of the federal poverty line.
  • Idaho Proposition 2 is a measure that would change the eligibility requirements for Medicaid to include more people, specifically those who are less than 65 years old and whose income is 133 percent of the federal poverty level or below, but who do not qualify for coverage through other state insurance.
  • Montana I-185 is a measure that would raise taxes on tobacco products by $2 per pack for cigarettes, or 33 percent of the wholesale price of all other tobacco products, and use that revenue to fund expanded Medicaid coverage.