Election recap: The context may change, but the goals don’t

Now that we’ve had some time to process the outcomes of this general election, I wanted to provide a recap of Tuesday’s election results and some thoughts about how the election results will impact HCF’s policy work in the coming years.

National Election Results

While it is too early to know the impact of the election on health reform at the national level and on our prospects to expand Medicaid regionally, it is clear that there will be renewed and serious discussion about repealing the Affordable Care Act (ACA). With Republicans maintaining majorities in both the House and Senate and President-elect Donald Trump expressing support for an ACA repeal, there is a real possibility that the ACA will be repealed or heavily changed in the coming year. Here are a couple good articles on the subject:

We can expect renewed discussion on health care in the country. Now, more than ever, it is critical that consumers are part of that conversation. From its inception, the ACA attempted to strike a delicate balance between affordability for consumers and sustainability for insurers, all against a backdrop of varying health risks. Some components of the ACA have worked tremendously well, resulting in increased health care access for millions of Americans, while others have been fraught with difficulty. In the midst of national conversations on the future of the ACA, it is important to keep the goal of increased and affordable access central to the conversation.

Missouri Landscape

Republicans swept statewide races in Missouri, including Eric Greitens winning the gubernatorial race.  Governor-elect Greitens has publicly expressed his opposition to Medicaid expansion. Further, the Missouri General Assembly held strong for Republicans with the House tally at 117 Republicans and 46 Democrats. The Senate Republican majority will be 25 to 9 Democrats. 

Kansas Landscape

Despite national sentiments, the state of Kansas shifted toward more moderate and Democratic elected representatives, many of whom have publicly expressed support for Medicaid expansion. In addition to primary wins by moderate Republicans, the general election saw 13 Democrats elected to the Kansas House and one elected to the Senate, which translates to a considerable growth in support for Medicaid expansion. See here for a nice summary by the Kansas Health Institute.

Missouri Cigarette Tax Measures

Both cigarette tax measures failed by a wide margins, with Constitutional Amendment 3 (aka “Raise Your Hand for Kids”) losing by an 18-point margin and Proposition A (supported by the Missouri Petroleum Marketers and Convenience Store Association) losing by 11 points. Despite HCF’s history of supporting increased cigarette taxes as a tool to prevent youth tobacco initiation, we did not support either measure, both of which were funded by tobacco companies and structured to minimize their impact on tobacco use. Together with our partners, we pledge our continued focus on reducing the tobacco burden in Missouri.  We look forward to exploring future opportunities for meaningful change that will reduce smoking and save lives.

Jackson County Measures

HCF provided grant funding to support two successful measures in Jackson County, MO:

  • The Jackson County Children’s Fund (Question 2) passed with 58-percent support. HCF, particularly Program Officer Donna Bushur, partnered with area social service agencies to propose this one-eighth of a cent sales tax, which is projected to raise between $12 million and $15 million annually. Revenue will fund supportive services for at-risk children and youth. 
  • The COMBAT tax (Question 1) was renewed with 74-percent voter support. First passed in 1989, the quarter-cent sales tax will be extended for nine years and is expected to generate around $23 million per year for anti-drug and violence prevention programming.

In the coming months, there will be a lot of discussions and predictions and uncertainty. While the context under our feet has changed considerably, we remain focused on our mission of providing leadership, advocacy, and barriers to eliminate barriers to health for the uninsured and underserved in our service area. We look forward to working with community members and policymakers to improve the health of the KC region.


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HCF's Local Health Buzz Blog aims to discuss health and health policy issues that impact the uninsured and underserved in our service area. To submit a blog, please contact HCF Communications Officers, Jennifer Sykes, at jsykes@hcfgkc.org.

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