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Judge orders LePage to implement voter-approved Medicaid expansion

Republicans may have set out to kill "Obamacare," but the ACA's Medicaid expansion keeps taking progressive steps forward.
Paul LePage
Gov. Paul LePage speaks to reporters shortly after the Maine House and Senate both voted to override his veto of the state budget, Wednesday, June 26, 2013, at the State House in Augusta, Maine.

Looking at a map of states that have embraced Medicaid expansion through the Affordable Care Act, the northeast stands out. Every state east of Lake Michigan and north of Virginia has already taken advantage of the opportunity, to the benefit of millions.

Maine's path, however, has been far more complicated. As regular readers may recall, the state's legislature made repeated attempts to pass Medicaid expansion, but Gov. Paul LePage (R) wouldn't budge, blocking it at every opportunity. Last fall, Maine voters took matters into their own hands and easily passed the health care policy through the ballot box.

But LePage still balked, refusing to implement Medicaid expansion. Not surprisingly, the matter ended up in court, where the Republican governor, nearing the end of his second term, suffered a predictable defeat yesterday. The Portland Press Herald  reported:

A Superior Court judge ruled Monday that the Maine Department of Health and Human Services and the LePage administration must follow the voter-approved Medicaid expansion law and submit a state plan amendment next week that sets the health coverage in motion for thousands of low-income Mainers.The court set a June 11 deadline for the state to file the amendment with the federal government.

Though the governor's office can appeal this ruling, it increases the likelihood that Maine will implement the policy and expand coverage to roughly 70,000 low-income Mainers.

This comes less than a week after policymakers approved Medicaid expansion in Virginia, bringing the new total of states that have embraced the policy to 33 (including Maine).

Vox added yesterday, meanwhile, that this total may soon reach new heights.

The next big development to watch will be Medicaid ballot initiatives in four red states: Utah, Idaho, Nebraska, and Montana. (Montana currently participates in Medicaid expansion, but the program is set to end in 2019, hence the ballot effort to extend it.)The Utah lieutenant governor has certified that the ballot initiative there has gathered enough signatures to get a vote in November. Organizers in Idaho believe they've turned in enough votes to also make a ballot, but the state has until July 5 to certify the results. In Nebraska and Montana organizers are still gathering signatures.

As the dust settled on the 2016 election, the conventional wisdom said that "Obamacare" was as good as dead. Progressive steps forward like these seemed like a pipe dream.

And yet, here we are.