Jennie Pirkl of Mainers for Healthcare declares victory on the statewide Medicaid expansion ballot question in Portland Tuesday night.

Maine voters said clearly on Tuesday that they support expanding the state’s Medicaid program despite uncertainty caused by President Donald Trump’s and congressional Republicans’ efforts to repeal the Affordable Care Act

With 70 percent of precincts reporting at 10:25 p.m. Tuesday, vote tallies showed support for expansion at 59 percent and opposition at 41 percent.

The Medicaid expansion question came to the ballot after years of legislative debate and rejection, including five bills that were vetoed successfully by Republican Gov. Paul LePage. Tuesday’s passage of Question 2 will leave an indelible mark on the termed-out governor’s legacy.

The “Yes On 2” campaign celebrates.

Posted by The Bangor Daily News on Tuesday, 7 November 2017

The question appeared on the 2017 ballot as a result of a blazing-fast collection of the required 61,123 signatures of registered Maine voters. The bulk of those signatures were collected on Election Day in November 2016, when staff and volunteers for Maine Equal Justice Partners and other advocacy groups fanned out across Maine.

In all, the group gathered more than 65,000 signatures.

To date, 31 states have opted to expand their Medicaid programs under the provisions of the Obama-era Affordable Care Act, which promises the federal government will pay 90 percent of expansion costs into the future. Maine is among 19 states that haven’t. However, the assault by Trump and congressional Republicans throws the future of the bonus funding and the overall future of government-subsidized health care into question.

With that effort active in Congress, many looked to Maine’s referendum as a potential national barometer on conservative health care principles.

“Maine has shown the way for the rest of the country,” said Jennie Pirkl, the campaign manager for the Yes on 2 campaign. “Voters have sent a clear message to Augusta, Washington and the rest of the country that we want more health care, not less.”

Robyn Merrill, campaign co-chair for “Yes On 2,” which seeks to expand Medicaid coverage in Maine, talks about the voting results at Bayside Bowl in Portland.

Posted by The Bangor Daily News on Tuesday, 7 November 2017

The campaign has been intense. In September, legislative opponents successfully lobbied Secretary of State Matt Dunlap’s office to alter the wording of the question, replacing a reference to “insurance” with “health care coverage.” Groups favoring the initiative far outspent opponents. According to Maine Ethics Commission data, proponents spent nearly $1.9 million through Monday, compared with about $358,000 spent by opponents.

Passage of Question 2 will make Medicaid — or MaineCare, as it is called in Maine — available to approximately 70,000 more Mainers with incomes between 101 percent to 138 percent of the federal poverty level. That’s $16,643 a year for an individual and $39,716 for a family of five.

Question 2 also extends coverage to adults who are not disabled and who don’t have children, which is a change from current law. The bill, which takes effect 30 days after the governor certifies the official results, requires the Maine Department of Health and Human Services to file its plan for expansion with the federal government within 90 days.

The Legislature’s Office of Fiscal and Program Review estimates that expansion will require an annual state appropriation of nearly $54.5 million and a federal appropriation of $525 million a year.

The bill could face problems in the Legislature. Lawmakers could vote to repeal or alter the referendum’s wording and scope, just as they have for several citizen-initiated referendums in recent years. Most Republicans are against expansion, and the GOP has majority control of the Senate.

House Speaker Sara Gideon, D-Freeport, hailed the results.

“It is now the responsibility and the duty of the governor and the Legislature to fully and faithfully implement this law,” she said in a written statement.

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Christopher Cousins

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.