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Grant Burningham, who lives in Bountiful, Utah, worked to get a referendum on Medicaid expansion on the Utah ballot in November. Kim Raff for NPR hide caption

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Kim Raff for NPR

Voters In 4 States Set To Decide On Medicaid Expansion

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Organizers with Idahoans for Healthcare have been driving this green vehicle around the state to campaign for Medicaid expansion. Phil Galewitz/Kaiser Health News hide caption

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Phil Galewitz/Kaiser Health News

When one of Jose Nuñez's retinas was damaged by diabetes in 2016, the Los Angeles truck driver expected his Medicaid managed care policy to coordinate treatment. But Centene, the private insurer that manages his policy, gave him the runaround, he says, and he lost sight in that eye. Heidi de Marco/KHN hide caption

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Heidi de Marco/KHN

Massachusetts wanted to negotiate prices and stop the use of some of the most expensive drugs in its Medicaid program. The federal government said no. Paul Marotta/Getty Images hide caption

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Paul Marotta/Getty Images

"We would not be able to foster without Medicaid," says Sherri Croom of Tallahassee, Fla. Croom and her husband, Thomas, have fostered 27 children in the past decade. They're pictured here with four adopted children, two 18-year-old former foster daughters and those daughters' sons. Courtesy of the Croom family hide caption

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Courtesy of the Croom family

Ohio Gov. John Kasich, a Republican, is eager to preserve an expansion of Medicaid that he pushed through, despite opposition from other members of his party. Ron Schwane/AP hide caption

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Ron Schwane/AP

Texas officials are requiring that people who comment at Medicaid meetings on pharmaceuticals disclose more details about their ties to industry. George Rose/Getty Images hide caption

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George Rose/Getty Images

Cashiers, cooks, delivery people, fast-food workers and their supporters rallied outside New York City Hall in 2017. Their influential union, the Service Employees International Union, also includes about half a million home health aides. Pacific Press/LightRocket/Getty Images hide caption

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Pacific Press/LightRocket/Getty Images

Drug costs are the fastest growing part of state Medicaid budgets. asiseeit/Getty Images hide caption

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asiseeit/Getty Images

States Question Costs Of Middlemen That Manage Medicaid Drug Benefits

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In the mountain town of Juyaya, Puerto Rico, last October, children watched as U.S. Army helicopters brought a team of physicians to assess the medical needs of the local hospital and residents. Going forward, health economists say, the U.S. territory will need continued federal help to deal with its overwhelming Medicaid expenses. Carolyn Cole/Los Angeles Times via Getty Images hide caption

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Carolyn Cole/Los Angeles Times via Getty Images

Republican Gov. Doug Ducey speaks about a variety of issues during an interview in his office at the Arizona Capitol in May 2018, in Phoenix. Ross D. Franklin/AP hide caption

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Ross D. Franklin/AP
Paul Blow for NPR

Investigation: Patients' Drug Options Under Medicaid Heavily Influenced By Drugmakers

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Juan Lopez Aguilar (left), a Maya man who fled violence in Guatemala three years ago, tells Dr. Nick Nelson he fears returning to the land of his birth. "There are a lot of gangs," he tells the doctor. "They want to kill people in my community." Heidi de Marco/Kaiser Health News hide caption

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Heidi de Marco/Kaiser Health News

Medical Clinics That Treat Refugees Help Determine The Case For Asylum

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Nebraska resident Nick Carpenter listens as Becky Gould explains the Medicaid expansion petition in early July. Fred Knapp/NET News hide caption

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Fred Knapp/NET News