This week, a state judge in Maine ordered the administration of Trumpy Governor Paul LePage to proceed with expanding the state’s Medicaid program to 70,000 more citizens who earn less then 138 percent of the federal poverty limit, or $24,600 for a family of four.
The expansion, which the state’s voters approved by referendum at the end of last year, was meant to kick in next month, but the administration has been stonewalling and missed its April deadline to present a plan for implementation, so advocates sued. Governor LePage, a Republican who has been called “unhinged” by the editorial board of the Washington Post because of his irredeemably racist comments (suggesting that the state’s opioid problem is caused by black men bringing heroin to Maine from out of state who “impregnate a young white girl” while they’re visiting), has vetoed five separate bills that the statehouse passed to expand Medicaid in the state.
The ballot initiative was the first successful effort in the country to put Medicaid expansion in front of voters—it passed by 59 percent of the vote. Since then, organizers in Idaho and Utah have collected enough signatures to put Medicaid expansion on the ballots in those states in November, and activists in Nebraska and Montana are still collecting signatures.
Maine Superior Court Judge Michaela Murphy wrote that the LePage administration’s inaction on the Medicaid expansion is “a complete failure to act” on the ballot measure, which she called “clear and unambiguous,” according to The New York Times. She required that the administration provide a plan for implementation by next week to allow for coverage to kick in on schedule July 2.
Maine is one of 19 states that have not expanded their Medicaid offerings since passage of the Affordable Care Act (ACA), ostensibly because it would be too expensive, despite provisions requiring the federal government to pay most of the costs. Because the ACA didn’t provide subsidies for people purchasing private health insurance plans below a certain income level, expecting them to be covered by Medicaid, the citizens of non-Medicaid-expansion states who earn too much for their stricter Medicaid requirements but less than the level at which subsidies kick in have had to pay full price on the private market for insurance.
Other states have expanded their Medicaid programs after initially refusing the free federal money. Last week, Virginia passed legislation expanding coverage to 400,000 people—a move that Democratic Governor Ralph Northam campaigned on heavily before his win last fall.
Since the failure of the Republican effort to repeal Obamacare last year, polling has shown the popularity of the health insurance legislation to be at an all-time high, and the expansion of Medicaid has taken on a life of its own as a progressive issue in red states that have been allowing low-income residents to languish in the health coverage gap between Medicaid eligibility and ACA subsidies. Polling shows that it’s not just Obamacare and Medicaid that are gaining favor among voters, but also Medicare for all, which will hopefully gain steam as voters mobilize around health care as an issue this fall.