In 2012, the U.S. Supreme
Court held that the Medicaid expansion under the Affordable Care Act (ACA) should
be determined by each state. Since then, several governors have fought against expansion
in their states. Maine Gov. Paul LePage was one of several Republican governors
who refused to accept the ACA’s federal funding to implement the expansion in
the aftermath of the 2012 ruling.
After
several failed attempts by the Maine Legislature, Medicaid expansion advocates
gathered signatures and put the issue on the 2017 ballot. Nearly 60% voted in
support of the measure, making Maine the first state in the nation to approve
Medicaid expansion through a ballot initiative. However, Gov. LePage refused to
support the initiative. Last month, a Maine judge ordered Gov. LePage to follow
through on expanding the Medicaid program with a Dec. 5 deadline for the state
to make meaningful progress on setting up the health care expansion. In
January, Gov. LePage will be replaced by incoming governor Janet Mills, a
Democrat and former attorney general who has vowed to make implementing
Medicaid expansion her top priority. After
the successful referendum in Maine, advocates in Idaho, Nebraska and Utah
worked to get Medicaid expansion initiatives on their state’s ballots, and all
three passed, leading many to believe that ballot initiatives and courts will expand
Medicaid in hold out states.