LEWISTON — Since the introduction in 2014 of widespread coverage for tens of thousands of individuals and families in Maine by virtue of the Affordable Care Act, we have enjoyed a significant drop in the number of people without insurance coverage in Maine, from 16.1 percent in 2013 to 8.6 percent in 2016. Now, with open enrollment upon us, it’s time for coverage renewal. It’s also time to expand Medicaid, in order to ensure a seamless safety net that will improve health outcomes and workforce readiness and invest in Maine’s future.

The need for Medicaid expansion is ever present. Despite the enrollment gains that we’ve observed since 2014, this opportunity doesn’t extend to everyone. Those beneath the poverty line – $12,060 of income per year for an individual – do not qualify for any help with premiums, making coverage unaffordable. Whether disabled, in between jobs, older students or simply low-income workers without adequate employment benefits, these fellow Mainers fall through the cracks of society’s disjointed supports.

There is a strong, nonpartisan understanding of and support for making sure more people in Maine have access to health insurance. When people don’t have health insurance, they put off getting the care that they need. They are sicker and less able to work. They develop acute health care crises that would be otherwise avoidable through access to care. Right now, for too many Mainers health care is the nearest emergency room, as they defer care for lack of coverage until an acute crisis boils over.

Lack of access to quality, affordable health care coverage hurts families, but it also hurts our economy and weakens our health care system for all of us. Uncompensated sick care imposes increasing costs to our already strained safety net and charity care providers. These costs are also passed on to commercial insurance through higher charges by hospitals and health systems. This in turn directly increases insurance premiums, which subsequently makes it harder for businesses and deters yet more people from coverage.

With Medicaid expansion, we can close these gaps to needed health care before conditions worsen and become debilitating, acute crises. Moreover, the benefits of expansion extend beyond just those who will now have health care coverage and access to treatment: We all benefit from mending the holes in the safety net. Expansion will help to strengthen hospitals and clinics in Maine so that they are able to continue to provide care for everyone in the communities that they serve.

The widespread benefit that results from shoring up the gaps in coverage has been experienced in other states that have already taken this important step forward. In states that have expanded access to health insurance, premiums for people who buy insurance on the private market have grown more slowly than in non-expansion states. In addition, results among states that have expanded Medicaid show that the number of people without health insurance has fallen even more than among states that haven’t, and access to medical care has been significantly improved, leading to better health.

As president and CEO of Community Health Options, our not-for-profit health insurance company is committed to providing affordable, high-quality benefits that promote health and well-being to our members. We believe in the idea that health care can be better and more affordable when doctors, patients, health insurers and employers all work together. As a company with a significant share of the individual market, I get asked about the impact of a Medicaid expansion on our membership at Community Health Options. My response is always unequivocal: We will all do better if coverage were seamless and there was continuity of coverage despite variations in income or work status.

When people are in better financial standing to come back to coverage through the marketplace, they will be coming back without as many acute care needs or a backlog of unattended health concerns. This continuity provides for better health outcomes and improved work readiness and lowers the upward pressure on premiums for everyone.

Now on the eve of open enrollment, Maine voters also have a chance to show that we want more people to have health insurance, not fewer. More than 66,000 Mainers – from every county in the state – joined me in signing the petition to put Question 2 on the ballot, and I hope that you join me at the ballot box, too. It’s time for Maine to join the majority of states that have expanded Medicaid. Expansion is a smart move, and it’s the right thing to do.