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Maine Election Medicaid

Supporters of Medicaid expansion celebrate their victory, Tuesday, Nov. 7, 2017, in Portland, Maine. Maine voters say they want to join 31 other states in expanding Medicaid under the Affordable Care Act, the signature health bill of former President Barack Obama. (AP Photo/Robert F. Bukaty)

JEFFERSON CITY — A political nonprofit that has assisted Medicaid expansion ballot initiatives in four Republican-led states is weighing whether it should target Missouri next year.

The Fairness Project, a Washington-based 501(c)(4) nonprofit that does not have to reveal its donors, has contributed $31,022 to the Healthcare for All political action committee since last month, according to the Missouri Ethics Commission.

Healthcare for All filed registration paperwork on March 20 to support Medicaid expansion. It had reported no major donations until The Fairness Project wrote a $7,500 check on July 24. The Fairness Project donated an additional $23,522 on Monday.

The Fairness Project had also donated $2,495 in March.

Representatives with Healthcare for All and The Fairness Project did not say what the money was for, but both groups said they are testing the possibility of a ballot initiative for next year.

Said Jonathan Schleifer, executive director of The Fairness Project: “We are working together with a coalition of Missouri organizations as they explore a potential ballot initiative to expand Medicaid, which would deliver health care for hard working families and bring billions of tax dollars back to the state to create jobs and keep hospitals open.”

Sidney Watson, treasurer of Healthcare for All and a law professor at St. Louis University, described the PAC as “an exploratory entity intended to help organizations across the state decide whether we should try to put Medicaid expansion on the ballot in 2020.”

She anticipated a decision by the end of summer. Supporters would need to collect more than 100,000 signatures by next May to place an initiative on the ballot.

Colin Diersing, spokesman for The Fairness Project, declined to make a list of donors available, but said the group receives small-dollar donations online as well as foundation grants and large individual donations.

The Service Employees International Union-United Healthcare Workers West, in California, kick-started the The Fairness Project in 2015 and continues to donate, Diersing said.

Under the Affordable Care Act, government-sponsored Medicaid health care coverage was expanded to cover individuals making up to 138% of the federal poverty level — $17,322 for an individual this year, according to the U.S. Department of Health and Human Services.

The U.S. Supreme Court ruled in 2012 the federal government could not force states to expand Medicaid, and 14 states, including Missouri, have refused to expand coverage even as many Republican-led states have moved forward with various expansion programs.

Though the federal government initially paid the entire cost of Medicaid expansion, states will be required to pay 10% of the cost starting in 2020.

The Fairness Project supported the first Medicaid-expansion-by-ballot initiative in 2017 in Maine. So far, more than 34,000 Maine residents have gained insurance coverage through the program, according to the state’s health department.

Last year, The Fairness Project backed successful initiatives in Idaho, Nebraska and Utah.

“Americans from red states who voted to expand Medicaid became a central part of the health care narrative that defined the 2018 election cycle, setting the stage for even more progress in 2020,” the group says on its website.

In Missouri, Watson said, people “want to help more than 200,000 Missourians get health coverage, keep rural hospitals open, and bring billions of our tax dollars home from Washington, D.C.”

Secretary of State Jay Ashcroft, a Republican, has approved three Medicaid expansion ballot initiatives for signature gathering, though Watson said there has been no organized effort so far to collect signatures.

“Those efforts are still in their early stages,” she said.

The Republican-led Legislature has rejected Medicaid expansion for years. Efforts peaked in 2014, when two Republicans proposed an expansion that would require working-age recipients to hold a job.

Missouri voters have a history of backing ideas that state Republican leadership has rejected.

Last August, voters doused a “right-to-work” law the Legislature approved the year before.

In November, voters increased the state’s minimum wage to $12 per hour by 2023, legalized medical marijuana, and approved a redistricting plan that might give Democrats more power in Jefferson City.

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