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Maine expands Medicaid by referendum with 60 percent approval

[JURIST] Residents of Maine on Tuesday voted to expand access to Medicaid [text] to an additional 70,000 low-income individuals under the Affordable Care Act (ACA) [text, PDF], making it the first state to implement this expansion by referendum. Maine was one of the remaining 19 states that refused to expand Medicaid under the ACA, and the referendum passed with 60% of the vote [Ballotpedia materials].

Maine Governor Paul LePage vetoed the previous five attempts by the State Legislature to expand the program. Responding [press release] to approval of the referendum, LePage said

The last time Maine experimented with Medicaid expansion in 2002 under then-governor Angus King, it created a $750 million debt to hospitals, resulted in massive budget shortfalls every year, did not reduce emergency room use, did not reduce the number of uninsured Mainers and took resources away from our most vulnerable residents - the elderly and the intellectually and physically disabled - Therefore, my administration will not implement Medicaid expansion until it has been fully funded by the Legislature at the levels [Department of Health and Human Services] has calculated, and I will not support increasing taxes on Maine families, raiding the rainy day fund or reducing services to our elderly or disabled.

Maine's [Department of Health and Human Services (DHHS) [official website] estimates that this expansion will cost Maine taxpayers approximately $315 million over the next five years. Furthermore, DHHS claims the expansion would not affect children or pregnant women [press release] but instead would "allow childless, able-bodied adults into the program and increase eligibility for parents of dependent children." Most of these individuals already have access to subsidized health care under the current system.

Maine's results come as proponents in other holdout states, including Utah [Salt Lake Tribune report] and Idaho [Bloomberg report], have taken steps to get the Medicaid expansion issue on their respective state ballots in 2018.

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