Ignoring LePage, Maine voters easily approve Medicaid expansion

Gov. Paul LePage speaks at a news conference at the State House, Jan. 8, 2016, in Augusta, Maine. (Photo by Robert F. Bukaty/AP)
Gov. Paul LePage speaks at a news conference at the State House, Jan. 8, 2016, in Augusta, Maine.

The map of states that have adopted Medicaid expansion through the Affordable Care Act has looked kind of funny for a while. While it's not surprising that the Deep South has resisted the progressive policy, every state north of West Virginia and Maryland has embraced Medicaid expansion -- with one exception that sticks out like a sore thumb.

Maine's legislature has already made attempts to rectify this and bring coverage to low-income families in the state, but Gov. Paul LePage (R) hasn't budged, blocking Medicaid expansion at every opportunity.

Yesterday, as the Portland Press Herald reported, the state's residents took matters into their own hands.

Maine voters passed a measure to expand Medicaid on Tuesday, giving about 70,000 Mainers health care coverage and making the state the first in the nation to approve Medicaid expansion at the ballot box.With 75 percent of Maine precincts reporting, the measure was favored by 59 percent of the voters. Support for the measure appeared to be strongest along the coast and in southern Maine, but it also was backed by voters in parts of more conservative northern Maine.

The number of states that have adopted Medicaid expansion now stands at 32 -- the most recent previous state was Louisiana, which embraced the policy nearly two years ago -- though Maine is the first state to do so through a ballot initiative.

This will likely give a boost to related efforts to health care advocates in Utah and Missouri, who are also trying to get the issue on their statewide ballots next year.

And while this is obviously good news for the Mainers who'll soon have health security they currently lack, there are a couple of broader angles to keep in mind.

The first is that for all of the White House talk about "Obamacare" being "dead," there's ample real-world evidence to the contrary. The open-enrollment period is off to a very good start, and Medicaid expansion is moving forward, whether health care opponents like it or not.

Second, it's worth keeping an eye on what happens next in Maine. There were other popular measures approved by the state's voters last year, but which haven't yet been implemented, thanks largely to Maine's far-right governor.

Yesterday was a progressive breakthrough for the state's health care system, but ensuring that Medicaid expansion is actually implemented will likely take some effort.

Update: Soon after publishing this post, LePage announced that he'll refuse to implement the state-approved policy unless state lawmakers appropriate funding to his satisfaction. Litigation appears likely.