Janet Mills

AUGUSTA, Maine — Before the end of her first day in office on Thursday, Gov. Janet Mills signed an executive order directing the Maine Department of Health and Human Services to “swiftly and efficiently” begin implementing voter-approved Medicaid expansion.

Mills, a Democrat, was sworn in as the state’s 75th governor Wednesday evening, and by Thursday afternoon, she fulfilled a campaign promise by moving to begin implementing expansion — which was blocked by Paul LePage, her predecessor — on her first day in office.

“This thing has been pending too long,” Mills said during a Thursday afternoon news conference.

In 2017, Maine became the first state to approve Medicaid expansion by referendum, but it was not implemented by LePage, a Republican who vetoed other proposals to expand the program to an estimated 70,000 Mainers five times during his tenure.

Last month, a state court judge rejected LePage’s attempt to stall an earlier ruling forcing his administration to implement the law, but it pushed the implementation date to Feb. 1. That ended a legal battle between the former governor and advocates that lasted for most of 2018.

Mills directed DHHS to begin implementation on Thursday, ordering it to partner with health care providers and patients to provide a communications and outreach strategy to help enroll eligible Mainers to speed up application processing. Between a July deadline for coverage in the law and late September, the state said 3,500 applications had been denied.

The new governor answered questions about the order on Thursday in her office with Jeanne Lambrew, her nominee to lead DHHS, and said she is moving quickly to implement the expansion so “we can help more Maine people access the health care they need.”

In addition to the executive order, Mills submitted a letter to federal regulators, laying out plans to implement expansion and attempting to answer questions they had raised about an expansion plan submitted by LePage’s administration after the judge’s December decision.

The question will now turn to funding the law. When Mills was attorney general last year, she proposed funding expansion in the short term by using tobacco settlement money. LePage vetoed a later legislative plan that incorporated some of that money.

On Thursday, Mills told reporters that she would submit a sustainable funding plan to the Legislature as part of her two-year budget proposal be released later this month.

The Legislature’s fiscal office has said expansion would cost the state $55 million in the first year — assuming every eligible person signed up immediately, though it’s unlikely. There were also $37.7 million in surplus Medicaid funds as of June 30 that have been floated by Democrats as a way to pay short-term expansion costs.

John Bott, a spokesman for minority Republicans in the House of Representatives, said Mills’ actions amounted to “spending the surplus and figuring out how to pay for it later.” Senate Minority Leader Dana Dow, R-Waldoboro, said Mills was “sticking with her promises,” but he wouldn’t want to touch state reserves or raise taxes to cover expansion costs.

“I want a sustainable economy,” Dow said.

Mills also told reporters she continues to study LePage’s request to attach work requirements and other limits to Medicaid eligibility, which was approved by the administration of President Donald Trump last month. Mills could pull the state out of that waiver early this year.

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Michael Shepherd joined the Bangor Daily News in 2015 after time at the Kennebec Journal. He lives in Augusta, graduated from the University of Maine in 2012 and has a master's degree from the University...