(Greg Kearney Cartoon)
(Greg Kearney Cartoon)
During the recent referendum campaign, Gov. Paul LePage and his Republican allies pulled out all the stops to scare voters into rejecting Medicaid expansion. They ran blatantly false ads claiming it would cause hunting and fishing fees to skyrocket and elderly people to be thrown onto the street as “able-bodied” layabouts and African immigrants get free health care. They even called in legendary crooner Pat Boone to make misleading robocalls against the measure, but apparently Pat Boone just doesn’t have the cachet he once did.

On Tuesday, 59 percent of Maine voters rejected the apocalyptic messaging to make Maine the first state in the country to pass Medicaid expansion by referendum.

In accepting the $525 million in federal funding, over 70,000 low-income Mainers, many of them among the ranks of the working poor, will finally have access to health care. The measure will allow people age 21 to 64 who earn up to 138 percent of the federal poverty level ($16,643 or less for an individual or $33,948 or less for a household of four) to qualify for MaineCare, the state’s Medicaid program. Under the new law, which will take effect in 45 days after the Legislature reconvenes, the federal government will provide 94 percent of the funding in 2018 and then cover 90 percent of the cost after 2020.

“Mainers have spoken,” said Steve Butterfield, policy director at Maine Consumers for Affordable Healthcare. “They join the Legislature, which has passed Medicaid expansion bills five times, to send a clear message. They are tired of leaving money on the table and tired of watching our federal tax dollars stay in D.C. They are ready to make smart investments in our people, our health, our hospitals, and our economy here at home.”

However, that doesn’t mean the governor won’t try to sabotage it. The nonpartisan Maine Office of Fiscal and Program Review estimates that the state will have to provide roughly $55 million to match the federal Medicaid funding, and the Maine Department of Health and Human Services must adopt rules for its implementation. But LePage says he will not implement the law until the Legislature appropriates the amount that his administration estimates it will cost — about a $100 million.

“Credit agencies are predicting that this fiscally irresponsible Medicaid expansion will be ruinous to Maine’s budget,” said LePage in a statement. “Therefore, my administration will not implement Medicaid expansion until it has been fully funded by the Legislature at the levels DHHS 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.”

Speaking to WVOM on Tuesday, House Republican Leader Ken Fredette (R-Newport), who is currently running for governor, echoed LePage’s talking points and said his caucus would not support any tax increases or using money from the rainy-day fund to put up the matching funds.

“We don’t just get to ask the question, ‘Do you want to buy a new car?’” said Fredette. “You have to answer the question, ‘How are you then going to pay for it?’ I think House Republicans are going to be very stingy, much like we were in this past budget conversation, about how are we going to continue to pay for an ever-expanding government.”

In a statement, Senate President Mike Thibodeau, who is also running for governor, expressed similar sentiments and did not commit to implementing the new law, even though his district overwhelmingly voted for it. In his radio appearance, Fredette said the vote was “urban versus rural Maine” and suggested major ballot measures and elections in cities like Portland, Bangor, Lewiston and Auburn swayed the vote in favor of Question 2. However, although Fredette’s district voted no on Question 2, most of the Republican-controlled districts across rural Maine voted in favor of the measure. In fact, despite the efforts of Reps. Deb Sanderson (R-Chelsea), Paula Sutton (R-Warren), Abden Simmons (R-Waldoboro), James Gillway (R-Searsport) and Jeff Hanley (R-Pittston) to block Medicaid expansion at every turn, the measure easily passed in all of their districts. Whether they will honor the will of their constituents remains to be seen.

But if LePage does not comply with the new law, Question 2 proponents say he is in violation of the Constitution. And Democratic lawmakers say they're not giving up until the will of the people is upheld. "Now that Medicaid Expansion is the law of the land in Maine, Democrats are resolute in our commitment to fully implementing the law," said Senate Democratic Leader Troy Jackson (D-Aroostook Cty.) in a statement. "Democrats will not give an inch in this fight, because it is a matter of life and death. We will give no quarter to anyone who tries to take health care away from those hardworking Mainers who have been allowed to fall through the cracks for too long."