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In Victory for Obamacare, Maine Voters Expand Medicaid

The vote signals support for the health-care law at a time when President Trump is taking major steps to reverse it.

Maine Legislature
A rally in support of health care in Maine.
(AP/Robert F. Bukaty)
This story is part of our 2017 elections coverage.

Maine voters said yes to what was likely the most closely watched ballot measure on Tuesday.

By voting to become the 33rd state to expand Medicaid, voters signaled support for President Obama's Affordable Care Act (ACA) at a time when President Trump is taking major steps to reverse it. With 67 percent of precincts reporting, 59 percent voted in support of expanding Medicaid.

It's the first state to expand Medicaid by popular vote.

The Maine Legislature had voted to expand Medicaid five times in the last five years. But every time the bill reached GOP Gov. Paul LePage's desk, he vetoed it.

"To have the public weigh in like this, it demonstrates not only public support for the Affordable Care Act, but more basically it demonstrates support to expand health care to low-income people," says Jesse Cross-Call, a senior policy analyst with the Center on Budget and Policy Priorities. 

Under the ACA, the federal government pays 100 percent of the costs of increasing Medicaid eligibility to people who make incomes up to 138 percent of the federal poverty line, which is $32,000 for a family of four. Gradually, the feds' bill drops to 90 percent.

Opponents of the Maine measure argued that expanding Medicaid there is different than any other state. In 2003, former Gov. John Baldacci expanded Medicaid coverage and subsidized private insurance. Medicaid costs ballooned, and eventually the state fell behind on Medicaid reimbursements for hospitals. When Gov. Paul LePage took office in 2011, he began dismantling the eligibility requirements down to only children, pregnant women and adults with dependents. 

“We already did this, we already tried this experiment. It can’t come back,” said Brent Littlefield, spokesperson for Welfare to Work PAC, a coalition against the ballot measure. 

Supporters of the measure said that with the federal government still picking up most of the tab for Medicaid expansion, there’s no reason not to try.

No state has expanded Medicaid since Trump won the presidency. While Cross-Call says it's too soon to say whether Maine will cause other state leaders to explore Medicaid expansion, "they'll certainly take notice," he says.

Republicans in Congress have spent this year trying to repeal and replace the ACA, and most of their attempts eliminated funding for Medicaid expansion, which proved to be a dealbreaker for Democrats and many Republicans. In fact, two Maine congressmembers -- Republican Sen. Susan Collins and Independent Sen. Angus King -- were instrumental in defeating those bills.

“In many ways, the debate about health care starts and ends in Maine,” said David Farmer, spokesperson for Mainers for Health Care, which supported expanding Medicaid.

This story is part of our 2017 elections coverage.

Mattie covers all things health for Governing.

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