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Nebraska Initiative 427, Medicaid Expansion Initiative (2018)
- General election: Nov. 6
- Voter registration deadline: Oct. 19
- Early voting: Oct. 9 - Nov. 5
- Absentee voting deadline: Nov. 6
- Online registration: Yes
- Same-day registration: No
- Voter ID: No
- Poll times: 8:00 a.m. to 8:00 p.m. Central Time and 7:00 a.m. to 7:00 p.m. Mountain Time
Nebraska Initiative 427 | |
---|---|
Election date November 6, 2018 | |
Topic Healthcare | |
Status Approved | |
Type State statute | Origin Citizens |
Nebraska Initiative 427, the Medicaid Expansion Initiative, was on the ballot in Nebraska as an initiated state statute on November 6, 2018.[1] The measure was approved.
A "yes" vote supported this initiative to require the state to provide Medicaid for persons under the age of 65 and with incomes equal to or below 138 percent of the federal poverty line. |
A "no" vote opposed this initiative to require the state to provide Medicaid for persons under the age of 65 and with incomes equal to or below 138 percent of the federal poverty line. |
Aftermath
On August 28, 2019, two uninsured Nebraskans represented by the advocacy group Nebraska Appleseed filed a lawsuit against the Nebraska Department of Health and Human Services to expedite Medicaid expansion enacted by Initiative 427. In April, Nebraska's DHHS announced the expansion would not occur until October 1, 2020. Petitioners requested that expansion occur by November 17, 2019.[2]
Election results
Nebraska Initiative 427: Medicaid Expansion Initiative |
||||
---|---|---|---|---|
Result | Votes | Percentage | ||
356,891 | 53.55% | |||
No | 309,533 | 46.45% |
Overview
What did Initiative 427 change about Medicaid in Nebraska?
Initiative 427 required the state government to provide Medicaid for persons under the age of 65 whose incomes are equal to or below 138 percent of the official poverty line. In 2018, this amounted to an annual income of $16,753 for an individual and $34,638 for a household of four. Initiative 427 required the Nebraska Department of Health and Human Services to file a state expansion plan with the federal Centers for Medicare and Medicaid Services on or before April 1, 2019.[1]
How was Initiative 427 connected to Obamacare?
Medicaid is a government program that provides medical insurance to groups of low-income people and individuals with disabilities. The Affordable Care Act (ACA), also known as Obamacare, provided for the expansion of Medicaid to cover all individuals earning incomes up to 138 percent of the federal poverty level. In 2012, the U.S. Supreme Court ruled in NFIB v. Sebelius that the federal government could not withhold funds from states that refused to expand Medicaid. The ruling had the practical effect of making Medicaid expansion optional for states.[3] In 2018, the federal government financed 94 percent of the costs of state Medicaid expansion. For 2020 and subsequent years, the federal government was set to cover 90 percent of the costs.[4] As of 2018, Nebraska was one of 17 states that had not expanded Medicaid under the ACA.[5]
Who was behind the campaigns surrounding Initiative 427?
Insure the Good Life, a political action committee, led the campaign in support of Initiative 427. Insure the Good Life raised $2.97 million. The campaign's largest donor was The Fairness Project, which contributed $1.69 million. According to The Fairness Project, the organization provided funding for "ballot initiative campaigns and drives a national narrative to elevate issues of economic fairness." No PACs had organized to oppose Initiative 427.[6]
What states voted on measures related to Medicaid expansion in 2018?
In November 2018, voters in Idaho, Montana, Nebraska, and Utah decided ballot initiatives concerning Medicaid expansion and the funding of expanded Medicaid coverage. In January, voters in Oregon approved Measure 101, thereby upholding 2017 legislation to provide funding for the state's portion of costs for expanded Medicaid coverage through a tax on healthcare insurance and the revenue of certain hospitals.
The Affordable Care Act, also known as Obamacare, was enacted in March 2010. Between 2013 and 2016, no statewide ballots featured measures related to Obamacare. In 2017, voters in Maine approved a ballot measure to expand Medicaid to persons under the age of 65 and with incomes equal to or below 138 percent of the federal poverty line. The measure was the first citizen initiative to implement an optional provision of Obamacare.
2018 measures:
Measure | Description | Status |
---|---|---|
Idaho Proposition 2 | Expand coverage to 138 percent of the federal poverty line | |
Montana I-185 | Extend expanded coverage and increase tobacco taxes | |
Nebraska Initiative 427 | Expand coverage to 138 percent of the federal poverty line | |
Utah Proposition 3 | Expand to 138 percent of the federal poverty line and increase sales tax | |
Oregon Measure 101 | Upheld health insurance tax to fund expanded coverage |
Text of measure
Ballot title
The ballot title was as follows:[7]
“ | Shall Nebraska statutes be amended to provide that the state shall amend its Medicaid state plan to expand eligibility for medical assistance to cover certain adults ages 19 through 64 whose incomes are one hundred thirty-eight percent (138%) of the federal poverty level or below as defined by federal law, and to maximize federal financial participation to fund their care?[8] | ” |
Full text
The full text of the initiative is available here.
Readability score
- See also: Ballot measure readability scores, 2018
Using the Flesch-Kincaid Grade Level (FKGL and Flesch Reading Ease (FRE) formulas, Ballotpedia scored the readability of the ballot title and summary for this measure. Readability scores are designed to indicate the reading difficulty of text. The Flesch-Kincaid formulas account for the number of words, syllables, and sentences in a text; they do not account for the difficulty of the ideas in the text. The secretary of state wrote the ballot language for this measure.
In 2018, for the 167 statewide measures on the ballot, the average ballot title or question was written at a level appropriate for those with between 19 and 20 years of U.S. formal education (graduate school-level of education), according to the FKGL formula. Read Ballotpedia's entire 2018 ballot language readability report here. |
Support
Insure The Good Life led the campaign in support of Initiative 427.[9]
Supporters
Officials
- Sen. Bob Krist (D-10), 2018 gubernatorial candidate[10]
- Sen. Lynne Walz (D-15), 2018 lieutenant gubernatorial candidate[11]
- Sen. Adam Morfeld (D-46)[12]
- Sen. Anna Wishart (D-27)[11]
- Sen. Justin Wayne (D-13)[11]
- Sen. Kate Bolz (D-29)[11]
- Sen. Carol Blood (D-3)[11]
- Sen. Sara Howard (D-9)[11]
- Sen. Lynne Walz (D-15)[11]
- Sen. John McCollister (R-20)[11]
- Sen. Tony Vargas (D-7)[11]
- Sen. Patty Pansing Brooks (D-28)[11]
- Sen. Sue Crawford (D-45)[11]
- Sen. Matt Hansen (D-26)[11]
- Sen. Mike McDonnell (D-5)[11]
- Sen. Dan Quick (D-35)[11]
Parties
Organizations
- AARP Nebraska[13]
- ACLU of Nebraska[13]
- Brain Injury Alliance of Nebraska[13]
- The Center for Rural Affairs[13]
- Central Nebraska Peace Workers[13]
- Children and Family Coalition of Nebraska[13]
- Community Action of Nebraska, Inc.[13]
- Families USA[6]
- The Fairness Project[6]
- Friends of Public Health[13]
- Health Center Association of Nebraska[13]
- Heartland Workers Center[13]
- League of Women Voters of Greater Omaha[13]
- League of Women Voters of Nebraska[13]
- Multicultural Coalition of Grand Island[13]
- National Association of Social Workers, Nebraska Chapter[13]
- National Council of Jewish Women – Nebraska[13]
- Nebraska AIDS Project[13]
- Nebraska Appleseed Center for Law in the Public Interest[13]
- Nebraska Association of Behavioral Health Organizations[13]
- Nebraska Association of Local Health Directors[13]
- Nebraska Hospital Association[13]
- Omaha Together One Community[13]
- Our Revolution[14]
- PFLAG Grand Island[13]
- Planned Parenthood Voters of Nebraska[13]
- Voices for Children in Nebraska[13]
Unions
Individuals
- Walter Scott Jr., philanthropist and former CEO of Peter Kiewit Sons' Incorporated[6]
- Warren Buffett, investor, philanthropist, and CEO of Berkshire Hathaway[6]
Arguments
Insure The Good Life provided the following argument on the campaign's website:[13]
“ |
Insure The Good Life's ballot initiative will bring $1.1 billion tax dollars back to Nebraska, sustain 10,000 jobs, and give Nebraskans a voice in expanding Medicaid. No one should be forced to decide whether they can afford life-saving care for themselves or their families – like cancer treatment or heart medication. But too many hardworking moms struggling to put food on the table and near-retirees who got laid off because of their age are forced to make those decisions every day. Making Medicaid available to people earning less than $17,000 a year will bring health coverage to over 90,000 struggling Nebraskans. Over two-thirds are Nebraskans with jobs who work hard but whose jobs don’t come with health coverage. They should have the protection of affordable health care. Nebraska voters deserve the right to choose a healthier future for their families, friends, and neighbors. We shouldn’t have to wait while politicians in Washington and Lincoln play politics with our health care.[8] |
” |
Opposition
Opponents
Officials
- Sen. Joni Albrecht (R-17)[15]
- Sen. Lydia Brasch (R-16)[15]
- Sen. Curt Friesen (R-34)[15]
- Sen. Jim Scheer (R-19)[15]
- Sen. Bruce Bostelman (R-23)[15]
- Sen. Tom Brewer (R-43)[15]
- Sen. Rob Clements (R-2)[15]
- Sen. Steve Erdman (R-47)[15]
- Sen. Steve Halloran (R-33)[15]
- Sen. Lou Ann Linehan (R-39)[15]
- Sen. John Lowe (R-37)[15]
Organizations
- Americans for Prosperity—Nebraska[16]
Arguments
Jessica Shelburn, director of Americans for Prosperity—Nebraska, said her group would work to defeat Initiative 427. Shelburn issued the following statement:[16]
“ |
Expanding Medicaid is not what our state needs. This proposal will make a bad problem worse by further straining a broken Medicaid program that already struggles to provide quality health care services for Nebraska’s most vulnerable citizens. We should be reforming Medicaid to make it work better for our most vulnerable populations, instead of exposing our state to massive tax increases and cuts to essential government services.[8] |
” |
Campaign finance
Total campaign contributions: | |
Support: | $2,966,975.18 |
Opposition: | $0.00 |
There was one ballot measure committee registered in support of the measure—Insure the Good Life. The committee had received $2.97 million. The committee had spent $2.95 million. The largest donor to the committee was The Fairness Project, which contributed $1.69 million.[6]
There were no committees registered in opposition to the measure.[6]
Support
The following table includes contributions and expenditure totals for the committee in support of the initiative:[6]
|
|
Donors
The following were the top five donors who contributed to the support committee:[6]
Donor | Cash | In-kind | Total |
---|---|---|---|
The Fairness Project | $1,073,004.33 | $618,705.67 | $1,691,710.00 |
Walter Scott Jr. | $200,000.00 | $0.00 | $200,000.00 |
Warren Buffett | $200,000.00 | $0.00 | $200,000.00 |
Nebraska Appleseed Center for Law in the Public Interest | $75,000.00 | $76,929.34 | $151,929.34 |
Nebraska State Education Association | $70,000.00 | $75,600.00 | $145,600.00 |
Methodology
To read Ballotpedia's methodology for covering ballot measure campaign finance information, click here.
Media editorials
Support
- The North Platte Telegraph: "Let’s be clear: Expanded Medicaid coverage likely wouldn’t survive our state’s next ag downturn. But rural Nebraska cannot survive without reliable access to health care. Without small-town hospitals, lives will be lost. For now, the federal funds are there. We conclude that our rural hospitals, today, need the extra Medicaid coverage as much as Nebraska’s working poor do. We reluctantly recommend a vote “FOR” Initiative 427 — followed by more responsible, sustainable solutions by our leaders to this problem and the other expensive ones facing our state."[17]
Opposition
- The Wall Street Journal: "Nebraska and Idaho’s ballot measures leave the funding details for another day, ostensibly because voters might figure out that expansion is more expensive than it appears. [...] Medicaid expansion is a bad fiscal and health-care bargain that looks worse as time passes. States like Kentucky are already looking for reforms like work requirements before the “free” money drowns their state fisc. Voters would be wise to reject the phony compassion and focus scarce resources on the poor and disabled."[18]
Background
Medicaid expansion under the ACA
- See also: Medicaid and Obamacare
The Affordable Care Act (ACA), also known as Obamacare, was signed into law on March 23, 2010.[19] The ACA provided for the expansion of Medicaid to cover all individuals earning incomes up to 138 percent of the federal poverty level, which amounted to $16,753 for individuals and $34,638 for a family of four in 2018 in the contiguous 48 states. For Alaska and Hawaii, the threshold was higher.[20][4][21] The law was designed to provide 100 percent of funding to cover the new recipients for the first three years and to cut off federal Medicaid funding to states that chose not to expand coverage. However, the United States Supreme Court ruled in National Federation of Independent Business v. Sebelius (2012) that the federal government could not withhold Medicaid funds from states that chose not to expand eligibility. According to the Kaiser Family Foundation, this ruling had the practical effect of making Medicaid expansion optional for states.[3] By January 1, 2017, 19 states, including Utah, had chosen not to expand eligibility.[22][23]
From 2014 to 2016, the federal government covered 100 percent of the costs of state expansion of Medicaid. In 2017, the total cost of expanded coverage that the federal government financed decreased to 95 percent. The ACA was designed to decrease the amount the federal government covers to 94 percent in 2018, 93 percent in 2019, and 90 percent in 2020 and subsequent years.[24]
The Affordable Care Act had not provided tax credits to adults with household incomes less than the federal poverty line because the law had aimed to cover these people under Medicaid. In states that did not expand Medicaid, many of these adults fell into a coverage gap in which they neither qualified for Medicaid nor for federal tax credits to purchase health insurance. As of 2016, around 2.6 million people fell into this coverage gap across the 19 states that did not expand Medicaid.[22]
Adoption of Medicaid expansion under the ACA
As of January 2022, a total of 38 states and Washington, D.C., had expanded or voted to expand Medicaid, while 12 states had not. The map below provides information on Medicaid expansions by state; for states that expanded, hover over the state to view the political affiliation of the governor at the time of expansion.[25]
Medicaid expansion on the ballot
Congress approved the Affordable Care Act, also known as Obamacare, on March 21, 2010, and President Barack Obama signed the legislation into law on March 23, 2010. Almost 20 weeks after the law's passage, voters in Missouri approved a ballot measure to oppose the individual mandate and employer mandate. The measure was the first to oppose Obamacare. Following the August 2010 vote in Missouri, voters in eight other states cast ballots on measures designed to oppose provisions of Obamacare. The American Legislative Exchange Council (ALEC), which developed model legislation that some of the ballot measures utilized, contended that the measures provided states with a legal framework to challenge Obamacare.[26] Opponents argued that the measures were symbolic, having no effect on the federal healthcare law.[27]
Between 2013 and 2016, no statewide ballots featured measures related to Obamacare. In 2017, voters in Maine considered a ballot measure to expanded Medicaid to persons under the age of 65 and with incomes equal to or below 138 percent of the federal poverty line. The measure, which was approved, was the first to implement a provision of Obamacare that, due to a court ruling, state governments were allowed to choose whether or not to enact. At the time, 19 states, including Maine, had chosen not to expand Medicaid. Inspired by the win in Maine, campaigns began in additional states to expand Medicaid through citizen-initiated ballot measures.[28][29]
Less than 80 days after the vote in Maine, another type of conflict related to Medicaid expansion was on the ballot in Oregon. Oregon Measure 101 was a veto referendum against assessments and taxes to provide funding for Medicaid expansion. The expansion was fully funded by the federal government from 2014 through 2016. In 2017, the federal government provided 95 percent of funding for Medicaid expansion, and the remainder was the responsibility of the state government. Federal funding for Medicaid expansion was scheduled to decrease to 94 percent in 2018, 93 percent in 2019, and 90 percent in 2020 and after. Oregon was the first state with a ballot measure, which voters approved, addressing how to fund Medicaid expansion.
Following is a list of statewide ballot measures related to Medicaid expansion and funding for expanded coverage:
2018 measures
- Oregon Measure 101 was on the ballot in January 2018. It was a veto referendum targeting the repeal of legislation designed to help fund Medicaid expansion costs through a tax/assessment on heathcare insurance premiums. Voters supported the bill by approving Measure 101.
- Idaho Proposition 2 qualified for the ballot as a citizen initiative and was designed to expand Medicaid eligibility to those under 65 years old whose income is 133 percent of the federal poverty level or below and who are not eligible for other state insurance coverage.
- Montana I-185 was on the ballot in Montana as a citizen initiative. I-185 was designed to extend expanded eligibility for Medicaid coverage and raise taxes on tobacco products to fund Montana's Medicaid expansion programs as well as other healthcare-related programs.
- The Nebraska Medicaid Expansion Initiative was on the ballot in Nebraska as an initiated state statute on November 6, 2018. It was designed to require the state to provide Medicaid for persons under the age of 65 and with incomes equal to or below 138 percent of the federal poverty line.
- Utah Proposition 3, the Medicaid Expansion Initiative, was on the ballot in Utah as an initiated state statute on November 6, 2018. Proposition 3 was designed to (a) expand Medicaid coverage to persons under the age of 65 and with incomes equal to or below 138 percent of the federal poverty line and (b) increase the sales tax from 4.70 to 4.85 percent to finance the state's portion of the costs expanded Medicaid coverage.
Pre-2018 measures
- Maine Question 2, the Medicaid Expansion Initiative, was on the ballot in Maine as an indirect initiated state statute on November 7, 2017. It was approved. Gov. Paul LePage (R) opposes expanding Medicaid in Maine and has refused to implement the law. On April 3, 2018, the state missed the deadline to file an application for Medicaid expansion with the federal government in order to secure funding by July 2018, as required by Question 2.
Measures that did not make the ballot
- The Montana Medicaid Expansion Initiative was proposed for the November 4, 2014 ballot in Montana as an initiated state statute. Proponents failed to collect enough signatures, and therefore it did not qualify for the ballot.
- The Ohio Medicaid Expansion Initiative was proposed for the November 4, 2014 ballot in Ohio as an indirect initiated state statute. Proponents failed to collect enough signatures, and therefore it did not qualify for the ballot.
- The Missouri Medicaid Expansion Initiative was proposed for the November 6, 2018 ballot in Missouri as an initiated state statute. Proponents did not submit signatures for the initiative, therefore the measure was not on the ballot.
Path to the ballot
The state process
In Nebraska, the number of signatures required to qualify an initiated state statute for the ballot is equal to 7 percent of registered voters as of the deadline for filing signatures. Because of the unique signature requirement based on registered voters, Nebraska is also the only state where petition sponsors cannot know the exact number of signatures required until they are submitted. Nebraska law also features a distribution requirement mandating that petitions contain signatures from 5 percent of the registered voters in each of two-fifths (38) of Nebraska's 93 counties.
Signatures must be submitted at least four months prior to the next general election. Signatures do not roll over; they become invalid after the next general election at least four months after the initial initiative application filing. Depending on when the initiative application is filed, petitioners can have up to just under two years to circulate petitions.
The requirements to get an initiated state statute certified for the 2018 ballot:
- Signatures: 84,908[30] valid signatures were required.
- Deadline: The deadline to submit signatures was July 6, 2018.
Signatures are submitted to the secretary of state. The secretary of state sends the appropriate signature petitions to each county, where county election officials verify the signatures. Upon receiving the signatures back from county officials, the secretary of state determines whether or not the requirements were met.
Details about this initiative
The ballot initiative was filed on March 9, 2018, and approved for signature gathering.[1] On July 5, 2018, supporters filed more than 133,000 signatures for the ballot initiative.[10] At least 84,908 (63.84 percent) of the signatures needed to be valid for the initiative to make the ballot.
Secretary of State John Gale certified the ballot initiative on August 24, 2018. He reported that 104,477 signatures were valid—almost 20,000 more than was required.[31]
Cost of signature collection:
Sponsors of the measure hired FieldWorks, LLC to collect signatures for the petition to qualify this measure for the ballot. A total of $727,178.67 was spent to collect the 84,908 valid signatures required to put this measure before voters, resulting in a total cost per required signature (CPRS) of $8.56.
How to cast a vote
- See also: Voting in Nebraska
Poll times
In Nebraska, all polling locations are open from 8:00 a.m. to 8:00 p.m. Central Time and 7:00 a.m. to 7:00 p.m. Mountain Time. An individual who is in line at the time polls close must be allowed to vote. Nebraska is divided between Central and Mountain time zones.[32]
Registration requirements
- Check your voter registration status here.
To register to vote in Nebraska, each applicant must be a citizen of the United States, a resident of the Nebraska county in which they are registering, and at least 18 years old by the first Tuesday after the first Monday in November. Citizens are eligible to register to vote on January 1 of the year they will turn 18 before the November general election. People convicted of a felony are ineligible to register to vote until two years after the terms of their sentence have been completed, and individuals who have been declared mentally incompetent by a court are ineligible to register to vote.[33][34] A voter registration application can be completed in person at the county clerk or election commissioner's office, the Department of Motor Vehicles, or other state agencies. In-person registration must be completed by the third Friday preceding the election if completed at the DMV or other state agencies. In-person registration at county election offices must be completed by 6 p.m. on the second Friday before the election. Applications returned by mail must be postmarked by the third Friday before the election.[35] Online applications must be submitted by midnight on the third Friday before the election.[36]
Automatic registration
Nebraska does not practice automatic voter registration.
Online registration
- See also: Online voter registration
Nebraska has implemented an online voter registration system. Residents can register to vote by visiting this website. The Nebraska State Senate enacted legislation allowing online voter registration in 2014, and the system was implemented in 2015.[37]
Same-day registration
Nebraska does not allow same-day voter registration.
Residency requirements
In Nebraska, citizens can register to vote the day they become residents of the state.[35]
Verification of citizenship
Nebraska does not require proof of citizenship for voter registration.
Verifying your registration
The Voter View site, run by the Nebraska Secretary of State’s office, allows residents to check their voter registration status online.
Voter ID requirements
Nebraska requires voters to present identification while voting.
Initiative 432, approved by Nebraska voters in November 2022, amended Article I of the state constitution to require voters to present valid photo identification in order to vote. Governor Jim Pillen (R) signed Legislative Bill 514 into law on June 1, 2023, in order to implement this policy change. Due to this legislation, Nebraska's voter ID requirement went into effect on April 1, 2024, in time for the state's 2024 primary.[38][39]
See also
Footnotes
- ↑ 1.0 1.1 1.2 Nebraska Secretary of State, "Medicaid Expansion Initiative Petition," accessed March 30, 2017
- ↑ U.S. News, "Nebraska District Court to Hear Medicaid Expansion Lawsuit," accessed September 11, 2019
- ↑ 3.0 3.1 Kaiser Family Foundation, "A Guide to the Supreme Court’s Affordable Care Act Decision," July 2012
- ↑ 4.0 4.1 Kaiser Health News, "Consumer’s Guide to Health Reform," April 13, 2010
- ↑ Kaiser Family Foundation, "Status of State Action on the Medicaid Expansion Decision," September 11, 2018
- ↑ 6.00 6.01 6.02 6.03 6.04 6.05 6.06 6.07 6.08 6.09 6.10 Nebraska Accountability and Disclosure Commission, "Campaign Finance," accessed September 12, 2018
- ↑ Nebraska Secretary of State, "Initiative 427," accessed October 8, 2018
- ↑ 8.0 8.1 8.2 Note: This text is quoted verbatim from the original source. Any inconsistencies are attributable to the original source.
- ↑ Insure the Good Life, "Homepage," accessed September 12, 2018
- ↑ 10.0 10.1 Lincoln Journal-Star, "Medicaid expansion decision appears headed to voters," July 5, 2018
- ↑ 11.00 11.01 11.02 11.03 11.04 11.05 11.06 11.07 11.08 11.09 11.10 11.11 11.12 11.13 The Grand Island Independent, "Initiative 427 will help families get health care," October 19, 2018
- ↑ The Hill, "Medicaid expansion likely to appear on November ballot in Nebraska," July 5, 2018
- ↑ 13.00 13.01 13.02 13.03 13.04 13.05 13.06 13.07 13.08 13.09 13.10 13.11 13.12 13.13 13.14 13.15 13.16 13.17 13.18 13.19 13.20 13.21 13.22 13.23 13.24 Insure the Good Life, "Our Fight," accessed September 12, 2018
- ↑ Our Revolution, "Our Initiatives," accessed September 23, 2018
- ↑ 15.00 15.01 15.02 15.03 15.04 15.05 15.06 15.07 15.08 15.09 15.10 1011 Now, "Senators' editorial opposing Medicaid Expansion ballot measure," October 18, 2018
- ↑ 16.0 16.1 Americans for Prosperity, "AFP-NE Vows to Mobilize Grassroots Activists to Defeat Medicaid Expansion Initiative," July 5, 2018
- ↑ The North Platte Telegraph, "Editorial: A most reluctant recommendation on Initiative 427," October 21, 2018
- ↑ The Wall Street Journal, "ObamaCare’s Red State Trap," October 29, 2018
- ↑ New York Times, "Obama Signs Health Care Overhaul Bill, With a Flourish," March 23, 2010
- ↑ 'US Department of Health and Human Services, "U.S. Federal Poverty Guidelines Used to Determine Financial Eligibility for Certain Federal Programs,"
- ↑ Office of The Assistant Secretary for Planning and Evaluation, "Poverty Guidelines," January 25, 2016
- ↑ 22.0 22.1 Kaiser Family Foundation, "The Coverage Gap: Uninsured Poor Adults in States That Do Not Expand Medicaid Coverage," Oct 19, 2016
- ↑ Cite error: Invalid
<ref>
tag; no text was provided for refs namedkkstatus
- ↑ Kaiser Family Foundation, "Understanding How States Access the ACA Enhanced Medicaid Match Rates," September 29, 2014
- ↑ HealthInsurance.org, "Medicaid," accessed January 10, 2020
- ↑ ALEC, "About ALEC’s Freedom of Choice in Health Care Act," accessed February 5, 2018
- ↑ Politico, "Ariz., Okla. reject insurance mandate," November 3, 2010
- ↑ Forbes, "In Red States, Medicaid Expansion Heads To 2018 Ballot Measures," December 24, 2017
- ↑ Mic, "Medicaid expansion could be the key to red-state Democratic victories in 2018," February 3, 2018
- ↑ This requirement is approximate. Since the Nebraska signature requirement is based on the number of registered voters at the time of filing, it can vary slightly.
- ↑ Lincoln Journal Star, "Medicaid expansion to be on the November ballot in Nebraska, Gale confirms," August 24, 2018
- ↑ Nebraska Statutes, "Section 32-908," accessed April 18, 2023
- ↑ Nebraska Secretary of State, “Nebraska Voter Registration Background,” accessed April 18, 2023
- ↑ Nebraska Secretary of State, “Felon Voting Rights FAQ,” accessed April 18, 2023
- ↑ 35.0 35.1 Nebraska Secretary of State, “Voter Information Frequently Asked Questions,” accessed April 18, 2023
- ↑ Nebraska Secretary of State, “Online Voter Registration Frequently Asked Questions,” accessed April 18, 2023
- ↑ Omaha World-Herald, “Online voter registration is coming to Nebraska,” September 5, 2015
- ↑ Nebraska Secretary of State, "Full text," accessed June 8, 2023
- ↑ Nebraska Secretary of State, "Election Day FAQ," accessed June 8, 2023
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