- Following a year and a half of in a legal and political morass, CMS has approved Maine's Medicaid expansion, bringing the total of states with expansions up to 36 plus the District of Columbia.
- Now, Mainers who earn up to 138% of the federal poverty line, or $28,676 for a family of three, are eligible for Medicaid. About 16,800 people have gained coverage under MaineCare since January, Democratic Gov. Janet Mills' administration said Wednesday.
- Maine voters approved the Medicaid expansion in November 2017 by a 60% majority for implementation no later than July 2, 2018. However, then-governor Paul LePage, a Republican, refused to carry out the measure last year citing financing concerns.
Medicaid expansion, allowed under the Affordable Care Act, has gained increasing bipartisan support in recent months, with surprising backing conservative states voting in support of broadening access to the federal health program in November's midterm elections. A Commonwealth Fund report highlights the benefits of Medicaid expansion, finding community health centers in expansion states have improved financial stability and ability to provide low-cost, quality care.
Most recently, Utah got the greenlight for a watered down Medicaid expansion earlier this month in a controversial plan that only expanded benefits to the poverty level, instead of to 138% of the poverty line as state voters supported. The program also includes work requirements and will end up costing the state more money than a full expansion, while covering fewer needy citizens.
Mills ousted LePage in November and signed an executive order on her first day in office to implement the expansion and gain approval from the federal government under the ACA. The expansion is expected to cover an additional 70,000 low-income Mainers to the over 280,000 currently enrolled in the state's Medicaid program.
Coverage is retroactive to July 2018 — the original date expansion would have been implemented, had LePage not obstructed it. LePage fought a drawn-out court battle against expansion advocacy groups from spring 2017 until late last year over the future of the expansion, but Mills took office before the case could be decided.
LePage argued in legal filings expansion would "prompt a fiscal crisis." However, with Wednesday's CMS approval, the federal government will cover roughly 90% of the tab, financing more than $800 million in costs for enrollees through Maine's 2021 fiscal year.
"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 in a statement.