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Next week, voters in three states consider whether to do something their state governments did not - expand the Medicaid health insurance program, as most states did under Obamacare. Here's NPR's Alison Kodjak.
ALISON KODJAK, BYLINE: It wasn't all that long ago that Grant Burningham was living in the woods.
GRANT BURNINGHAM: That's hard for me to talk about because I thought I had reached the end.
KODJAK: He's a former financial adviser from Bountiful, Utah. Back in 2001, he had a severe reaction to a medication, and it caused a constellation of strange symptoms.
BURNINGHAM: I literally got what might even be termed the boils of Job. I have scars all over my body now. And they even got up on my face. And you can see them now. Then I got some really strange, severe headaches and fatigue. And that was associated with blood pressure that got remarkably high.
KODJAK: He had severe digestive problems. His blood sugar fluctuated wildly. The problems became so debilitating Burningham couldn't work.
BURNINGHAM: I really didn't want to call myself disabled at first. What I really truly wanted was just basically some answers.
KODJAK: He lost his job and his health insurance. Eventually, he lost his home. Now he has a place to live but still can't get the care or even a diagnosis that might allow him to get back on his feet. But that could all change. Next week, Utah residents will be going to the polls to vote on whether the state will join 33 others and Washington, D.C., and expand Medicaid coverage to a lot more low-income adults like Burningham. Nebraska and Idaho also have the Medicaid question on ballots in their states. And in Montana, voters will decide whether to continue that state's Medicaid expansion or let it roll back. Voters are acting because politicians aren't following their wishes, says Jonathan Schleifer.
JONATHAN SCHLEIFER: The real gap on health care is not between Democrats and Republicans. It's between politicians and everyone else. Politicians have made health care a divisive, political issue. But when you ask most Americans whether they want more health care or less, they want more health care.
KODJAK: Schleifer is executive director of The Fairness Project, which worked to put Medicaid expansion on the ballot in the four states. Maine voters approved a ballot measure to expand Medicaid in 2017. But Governor Paul LePage has so far refused to implement the expansion. Utah lawmakers have come close to expanding Medicaid at least three times since 2014. But the state's House of Representatives opposed it. Earlier this year, lawmakers agreed to a limited expansion, but that needs approval from the federal government.
Burningham has been there through it all. He testified in the Utah Legislature several times over the years. This time around, he collected signatures from his friends at the Capitol to get the measure onto the ballot.
BURNINGHAM: I also sat very humbly and very quietly and maybe got two or three signatures a week over a six-week period at a food bank up in Ogden, Utah. And that's where I had spent most of my homeless time was in Ogden.
KODJAK: RyLee Curtis, campaign manager for the advocacy group Utah Decides, says Burningham has company.
RYLEE CURTIS: People like social workers or nurses, even doctors going out and collecting signatures because they're tired of having these patients come into their offices and not being able to help them because they're uninsured.
KODJAK: And religious leaders have also been active.
(SOUNDBITE OF ARCHIVED RECORDING)
JODI BUSHDIECKER: Good morning. My name is Reverend Jodi Bushdiecker. I serve as pastor of Bountiful Community Church, United Church of Christ.
CURTIS PRICE: My name is Reverend Curtis Price. I'm the pastor at First Baptist Church of Salt Lake City.
VINETTA GOLPHIN-WILKERSON: I am Reverend Vinetta Golphin-Wilkerson. I serve as pastor of Granger Community Christian Church, Disciples of Christ.
KODJAK: In a news conference in early October, 10 religious leaders called for voters to pass the expansion. One was Bishop Oscar Solis of the Catholic Diocese of Salt Lake City.
(SOUNDBITE OF ARCHIVED RECORDING)
OSCAR SOLIS: To promote the dignity and sanctity of life, we need to provide basic needs for people, and that includes health care.
KODJAK: The Mormon Church hasn't taken an official position on the ballot question, though some individual leaders have endorsed it. But David Barnes of Americans For Prosperity, which is campaigning against the measure, says states like Utah shouldn't risk expanding Medicaid because groups like his are still trying to repeal the Affordable Care Act.
DAVID BARNES: If states go ahead and expand Medicaid - assuming there's a big federal pot of money that's going to be available to them to do this - and then find out after the fact that they've expanded coverage for them but can't pay for it, that's going to be a problem for them. And so we're trying to keep states from making fiscal decisions based on laws that we're separately tried to change.
KODJAK: Barnes says Medicaid expansion is flawed because federal funding is more generous for the expansion population than for the children and disabled people that Medicaid was originally intended to help. In Utah, AFP has about 50 people on the ground working to defeat the measure. And they've called and visited more than 23,000 voters. But polls show that 59 percent of Utah voters favor the expansion, which could bring health insurance to 150,000 Utahns. Grant Burningham is optimistic that he'll be one of them.
BURNINGHAM: I think it's going to pass. I really do.
KODJAK: Alison Kojak, NPR News.
(SOUNDBITE OF ANAN RYOKO'S "UTAKATA")
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