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Medicaid Expansion Supporters Say They Have the Signatures to Force a Vote

Supporters of expanding Medicaid in Maine say they’ve collected enough signatures to put the issue before the Legislature, or the voters.

The citizen initiative has the potential to extend health insurance coverage to 70,000 Mainers. But with the future of the Affordable Care Act uncertain under a Donald Trump presidency, it’s unclear how and if Medicaid expansion could work, even if it is approved here in Maine.

As Maine voters went to the polls on Election Day last month, volunteers were also collecting signatures — enough to put the question of whether Maine should expand Medicaid on a future ballot.

“Collectively, we were able to gather over 65,000 signatures in one single day,” says Robyn Merrill, executive director of Maine Equal Justice Partners, an anti-poverty advocacy group that’s spearheading the citizen initiative campaign. “It was so clear, how this is a real serious issue that we need to address, and Maine people want more access to affordable health care, not less.”

It’s a provision of the Affordable Care Act that has also received support from state lawmakers, but Gov. Paul LePage has vetoed bills to expand Medicaid five times.

Under expansion, the federal government reimburses 100 percent of the cost through 2016. The government’s share then tapers to 90 percent by 2020. But the future of the federal health law is uncertain, with President-elect Donald Trump and Congressional Republicans vowing to repeal and replace the ACA.

“If this makes it onto the ballot, I’ll be curious to see if the window to expand Medicaid is still open. If the federal dollars are still there to do it,” says Maine Republican Sen. Eric Brakey, who has served as co-chair of the Health and Human Services Committee.

Brakey says for Maine’s sake, he hopes that window will close, because it will hurt taxpayers. He says there are other strategies to help people get health care.

“If the concern is cost, we need to be looking at ways to inject real price competition and incentives to bring costs down in the health care industry,” he says.

But Dr. Barbara Covey says for now, Medicaid expansion is still in play and the best option.

“We need to proceed locally with what we have available at this time,” she says.

As an emergency physician at Maine General Medical Center, Covey says she sees what happens when people delay routine, preventive care. They arrive in the ER, she says, with acute cardiac or respiratory problems, or advanced cancers that could have been caught earlier with screenings.

Not providing health coverage, argues Covey, also has a cost.

“This needs to be done, from a moral and a community perspective, in terms of caring for our population,” she says.

Backers of the initiative say they’ve gathered 65,000 signatures, and they’ll need more than 61,000 of those to be validated by the secretary of state’s office to put the the issue before the Legislature. Failing approval there, the measure could go on the ballot in either 2017 or 2018.