LINCOLN, Neb. (AP) — Nebraska voters will decide Tuesday whether to expand Medicaid under the federal health care law, a proposal that would extend coverage to thousands of low-income residents but create additional costs for lawmakers in next year's session.
They'll also decide races for U.S. Senate and House, governor and makeup of the state Legislature.
An estimated 90,000 uninsured Nebraskans could gain access to Medicaid if voters approve a ballot measure to expand coverage. After six failed attempts for expansion under the federal health care law, advocates bypassed the lawmakers who rejected it and took the issue directly to voters.
Under a Medicaid expansion, the federal government would cover 93 percent of the cost next year and 90 percent in subsequent years, while the state would pay the rest — from $40 million to $69 million annually.
Supporters say expanding Medicaid would benefit people who work but don't have health coverage. They also argue it would reduce the cost of uncompensated health care for the uninsured.
Opponents see the expansion as an unsustainable mandate that could divert money away from other needs.
Republican Gov. Pete Ricketts is seeking a second term but his Democratic challenger, state Sen. Bob Krist, hopes to score a surprise upset in the GOP-dominated state.
Ricketts has outraised Krist and is viewed as the favorite to win the race. He has pledged to continue advocating for property tax cuts if re-elected and pointed to his efforts to promote Nebraska businesses.
Krist has pitched himself as a governor who would work collaboratively with lawmakers to reduce property taxes. Krist also promised to maintain his reputation as a voice for nonpartisanship in the Legislature, where he served for 10 years.
Krist was a Republican, then briefly an independent before finally joining the Democrats because it provided an easier path to qualify for the ballot.
Ricketts, a former TD Ameritrade executive, is the son of billionaire Joe Ricketts and a co-owner of the Chicago Cubs.
U.S. SENATE RACE
U.S. Sen. Deb Fischer is favored in her bid for a second term as she faces Democratic challenger Jane Raybould, a Lincoln City Council member who has portrayed the Republican as loyal to her party even when it hurts the state.
Fischer has rejected the criticism, pointing to her work on various Senate committees that oversee farm policy and military services, including the U.S. Strategic Command at Nebraska's Offutt Air Force Base. She also has touted her credentials as a conservative who voted to cut taxes.
Raybould has cast herself as an outsider who would focus on lowering health care costs by changing but not eliminating the Affordable Care Act. She also pledged to promote rural economic development policies.
The candidates differed on their support for new U.S. Supreme Court Justice Brett Kavanaugh, who faced sexual assault allegations during his confirmation process. Fischer voted to confirm Kavanaugh while Raybould said the allegations merited further investigation.
Kavanaugh has repeatedly denied the allegations.
Nebraska's most closely watched congressional race will pit first-term Republican Rep. Don Bacon against Democrat Kara Eastman in the 2nd District, encompassing Omaha and most of its suburbs.
The district is traditionally the most competitive in Nebraska, having changed hands from Republican to Democrat in 2014 with the election of Brad Ashford. Bacon defeated Ashford two years later.
Unlike Ashford, who stressed his role as a centrist, Eastman has embraced a progressive platform that includes expanded Medicare, greater gun control and tuition-free college for families making less than $125,000 a year.
Bacon describes himself as a conservative and supporter of President Donald Trump who is open to compromise on issues including immigration, health care and climate change.
In the 1st Congressional District, Republican Rep. Jeff Fortenberry is favored to win an eighth term over Democratic challenger Jessica McClure, a former chemist with a law degree.
GOP Rep. Adrian Smith is also expected to win a seventh term in the overwhelming Republican 3rd Congressional District. He faces Democrat Paul Theobald, a historian and hog farmer.
Republicans will likely retain a strong majority in the officially nonpartisan Legislature, but there could be substantial changes due to a variety of factors, including term limits.
Although the GOP has dominated the Legislature, even a few additional seats could make it easier for conservative senators to advance their agenda. Republicans now outnumber Democrats 30-17 — three votes shy of the 33 needed to overcome the filibusters that thwarted dozens of bills this year.
However, even if Republicans gain those seats, Nebraska's system makes it hard to predict how legislation will fare. The Legislature has no official party leadership, so it's easier for individual senators to break ranks when they support or oppose a bill, or strike deals with senators from the other party.
Ricketts has responded by calling for more "platform Republicans" in the Legislature and funneling his own money into competitive legislative races.
Follow Grant Schulte on Twitter at https://twitter.com/GrantSchulte
For AP's complete coverage of the U.S. midterm elections: http://apne.ws/APPolitics