A judge on Wednesday ordered Maine Gov. Paul LePage to carry out the Obamacare Medicaid program expansion that voters approved more than a year ago through a ballot measure.
LePage, a Republican, soon will be ending his time as governor, but Kennebec County Superior Court Justice Michaela Murphy ordered the expansion to begin Dec. 5.
The governor’s office may still appeal the decision to the high court but won’t have much time to continue holding up proceedings. Democratic Gov.-elect Janet Mills, who will be sworn in Jan. 2, has said that her top priority when she takes over the role will be to expand the program.
The order is retroactive and will apply to people who had applied to be covered under Medicaid on or after July 2.
The latest order is part of an ongoing battle that has taken place ever since Maine residents voted last year to expand the program to anyone in the state making less than roughly $17,000 a year.
The way Obamacare was originally written, all states were supposed to expand the Medicaid program to low-income people. Before that it covered only certain groups, such as people with disabilities. A 2012 Supreme Court decision made the provision optional for states, and just over a dozen have still not moved to expand. Obamacare advocates have worked to get states to opt for expansion via ballot measure, an approach that has worked in Idaho, Utah, and Nebraska.
LePage, who vetoed five legislature-passed expansions during his tenure, has been holding up the expansion over fiscal concerns.
LePage has said he would not allow the expansion until the legislature finds a way to fund the program without tax hikes and without taking money from the state’s surplus funds. Murphy wrote in her order that the expansion could be paid for through the current Medicaid fund until May 2019, and that the legislature needed to address the issue.
Robyn Merrill, executive director of Maine Equal Justice, the group behind the lawsuit, called the order a “huge victory” for the state.
“The executive branch has a duty to carry out all the laws, not pick and choose, and today’s ruling holds them accountable,” Merrill said.
More than 90 percent of Medicaid expansion is paid for by the federal government, with the state responsible for picking up the rest. The arrangement can lead to millions of dollars in extra spending, and other states have paid for the program through taxes on hospitals or health insurance companies.
Mainers in November 2017 passed Medicaid expansion through a ballot measure that had the support of 59 percent of voters. Under the law, Maine was supposed to submit an application for expansion to the federal government by Apr. 3 and have the program expanded by July 2.
Murphy order the state in June to do the expansion, a decision upheld by the Maine Supreme Judicial Court in August. LePage filed the expansion request to the Trump administration in August, but the governor attached a letter to federal officials asking them to reject it. The larger legal battle continued, with debate centering on whether a program could be created without allocated funding.
As many as 80,000 Mainers are expected to be enrolled in Medicaid after the expansion.
