On her first day in office in January, Democratic Gov. Janet Mills signed an executive order to implement the expansion, which still required approval from the federal Centers for Medicare and Medicaid Services (CMS).
Maine’s previous governor, Republican Paul LePage, an adamant opponent of President Barack Obama’s signature Affordable Care Act, refused to act on expansion even though Maine voters resoundingly supported it in a 2017 ballot initiative.
“This approval marks the culmination of a long-overdue effort to fulfill the will of Maine voters and help tens of thousands of people access health care,” Mills said in a statement in response to CMS’ approval. “The benefits of expansion — including this injection of hundreds of millions of dollars of federal funds — will extend to rural hospitals, to businesses and to our economy as a whole.”
Mills said coverage for new Medicaid enrollees will be retroactive to July 2, 2018, when expansion would have been implemented had LePage not blocked it.
An Urban Institute study last year projected that expansion would make 56,000 more Mainers eligible for Medicaid, the health plan jointly run and financed by the federal and state governments. The same report projected that expansion would bring $151 million more federal dollars to the state. The federal government pays 93% of the costs of covering expansion populations, higher than it does for the nonexpansion population.
The Affordable Care Act, passed in 2010, made anyone with an income up to 138% of poverty eligible for Medicaid (an annual salary just over $17,200 for an individual), opening the program to childless adults. But a 2012 U.S. Supreme Court ruling gave states the option of not expanding.
As of now, 36 states and the District of Columbia have expanded Medicaid, according to an analysis by the Kaiser Family Foundation. As in Maine, voters in three states — Idaho, Nebraska, and Utah — voted for expansion last November.
The same Urban Institute report estimated that if the states that had not expanded Medicaid did so, the overall percentage of people without health insurance in those states would drop from 16.9% to 12.6% and translate to 4.5 million more people on the health insurance rolls.