Lone Medicaid Expansion Defeat Offers Lessons for Other States

Source: Michael Ollove, Stateline, December 17, 2018

Perhaps the chief takeaway from the rejected citizen initiative to expand Medicaid in Montana last month is this: Be careful when you poke a giant.

Montana was one of four red states with Medicaid expansion on the ballot, and the only one where it failed. And the reason why, many close observers both inside and outside of the state agree, almost certainly came down to a tactical decision to link expansion to an increase in the state’s tobacco tax.

Supporters thought that strategy would boost their effort with voters, but it attracted Big Tobacco into the fight, along with the $17.2 million it spent, much of it on a television advertising blitz. Opponents raised nearly $19 million to defeat the measure, finance reports filed with the state show.

Proponents, with about $9.7 million to spend, simply couldn’t keep up….