Gov. Paul LePage has turned his attention squarely at defeating the Medicaid expansion referendum on this November’s ballot, claiming again that broadening eligibility for the government-run program would drive the state into backbreaking debt.

LePage’s ardent opposition to Medicaid expansion is nothing new. He has vetoed bids to do so six times during his tenure, making Maine one of the minority of states that have not expanded the program under the Affordable Care Act. The health care law gives states the option to expand Medicaid, with the federal government initially funding at least 90 percent of the cost of expansion, but LePage says that’s a fallacy.

“It’s a boondoggle and it’s going to kill this state,” LePage said during a radio interview Tuesday morning on WVOM. “Within two years we’re going to be right back to where we were in 2010.”

When LePage took office in 2011, one of his first projects was paying off hundreds of millions of dollars of accrued Medicaid debt to Maine hospitals. Democratic Gov. John Baldacci, LePage’s predecessor, had been paying down the debt for years, but those efforts failed to keep up with the burgeoning state obligation to hospitals. LePage finished the job with a revenue bond supported by the state liquor contract.

Throughout his tenure, LePage has opposed a number of ballot initiatives before they went to a vote, then continued to slam them after Maine voters approved them. He will undoubtedly be at the tip of the spear during the next three months among opponents to the Medicaid expansion referendum, which proponents say would extend health care coverage to at least 70,000 Mainers. It would extend the program to qualified Mainers 65 years old or younger whose income is equal to or less than 133 percent of the federal poverty rate.

Concurrently, he continues to attack U.S. Sens. Susan Collins and Angus King, claiming that their recent votes against Republican efforts to repeal the Affordable Care Act constitute endorsements of Medicaid expansion and uncontrolled government health care spending..

“We are fixing our problems in Maine but to go back to the past is really, really bad,” LePage said.

MaineCare, which is Maine’s version of Medicaid, serves about a quarter of the state’s population, and eligibility depends on income, age and individual circumstances. The majority of beneficiaries are children and adults younger than 65, but the program spends the most money on elderly Mainers and people with disabilities, according to 2014 data.

According to, there are currently about 266,000 residents on MaineCare, with an income eligibility threshold of up to 100 percent of the federal poverty level for adults with children. Children and pregnant women are eligible for MaineCare at up to 209 percent of the federal poverty rate. Able-bodied childless adults are currently not eligible for MaineCare but would be after Medicaid expansion.

The federal poverty level is equal to an income of $11,880 a year for an individual and $24,300 for a family of four.

Maine Equal Justice Partners organized collection of the more than 61,000 signatures required to force the Medicaid expansion referendum. The organization gathered virtually all of the signatures it needed on Election Day in November 2016, when volunteers fanned out to polling locations across the state.

The wording of the Medicaid expansion referendum question is still in the draft stages and public comment on that issue is being accepted through Sept. 1. Maine Secretary of State Matthew Dunlap will host a drawing on Wednesday to decide the order of the referenda on the November ballot.

This item was originally published in Daily Brief, a free political newsletter distributed Monday through Friday by the Bangor Daily News to inform dialogue about Maine politics and government. To read more of today’s Daily Brief, click here. To have the Daily Brief delivered daily to your inbox, click here.

Christopher Cousins has worked as a journalist in Maine for more than 15 years and covered state government for numerous media organizations before joining the Bangor Daily News in 2009.