Supporters of a proposal to expand the Medicaid program in Maine say they have collected enough signatures to put a referendum question on the ballot next fall.
Maine Equal Justice Partners said they collected 65,000 signatures on petitions on Election Day alone, exceeding the nearly 62,000 required to get the measure on the ballot. Robyn Merrill, executive director of the group, said petition circulators have continued to gather signatures since Election Day but she couldn’t offer an estimate of the total number collected.
Merrill said the petitions could be submitted to the Maine secretary of state to get the question a place on the 2017 ballot. But she also said supporters hope the Legislature might act first.
If the Legislature passes an expansion plan, and overrides an expected veto by Gov. Paul LePage before the late-January deadline, there would be no need for a referendum, she said.
“It’s a solution that can’t wait,” she said. “All options are on the table and it’s ultimately about making this happen,”
State Sen. Thomas Saviello, R-Wilton, said he already has submitted a title for a bill to expand Medicaid coverage. The measure just needs to be fleshed out with legislative language to move to a vote, he said.
Saviello said the bill likely would be introduced as an emergency measure because that would provide an early indication of whether a LePage veto could be overridden. Emergency legislation, like a veto override, requires two-thirds votes in both the state House and the Senate.
Merrill said organizers also could wait until after Jan. 27 and submit the signatures for the 2018 ballot, when voter turnout is likely to be higher, with races for governor, U.S. Senate and House, and the Legislature. However, that’s not the preferred route, given the goal of acting quickly so more Mainers are covered by health insurance, she said.
Merrill said organizers are also cognizant of the uncertainty of the future of the Affordable Care Act in Washington. The expanded Medicaid funding that would provide health care coverage to 70,000 Mainers is part of the act, which President-elect Donald Trump and congressional Republicans have vowed to repeal.
Some Republican lawmakers, however, including Maine Sen. Susan Collins, have said they are wary of repealing the Affordable Care Act without having something to replace it. Some of the leaders of the repeal effort have said they favor a three-year sunset on the law while a replacement is readied but don’t expect to have a detailed plan before a vote on repeal.
Saviello said the state might be wise to expand Medicaid before a replacement is adopted. Some of the replacement plans could be dependent on whether a state has adopted expanded Medicaid coverage, he said.
“In the long run, the state’s going to be better off” with expanded Medicaid coverage, he said.
Saviello also said expanding Medicaid could help with the state’s problems with the growing use of opiates. Many of those who use the drugs, he said, don’t have health insurance coverage and about 25,000 to 30,000 people in Maine need treatment but don’t have access, according to the federal Substance Abuse and Mental Health Services Administration.
Dr. Mary Dowd, a doctor with the Milestone Foundation, which runs a Portland detox center, said lack of insurance is keeping many drug users from getting help.
“It’s the primary reason,” she said. “If you have insurance, you can get help.”
Dowd said suboxone, a medication used to help treat those with opiate addictions, costs about $600 a month for a standard dosage. And there are other costs for treatment, she said, including doctor visits and counseling.
In addition to those who would get insurance coverage under a Medicaid expansion, about 84,000 Mainers receive health insurance from a marketplace set up as part of the ACA, which also provides subsidies for insurance for some who get coverage.
A state legislative study estimates that it would cost the state $93 million to expand Medicaid through 2019, but it would also bring in $1.2 billion in federal funding.