Mainers for Health Care rally outside the State House prior to then-Gov. Paul LePage's State of the State address on Feb. 13, 2018, in Augusta. The coalition that supported the successful Yes on 2 campaign to expand Medicaid in 2017 said LePage and his allies in the Legislature were trying to block Medicaid expansion, which is now state law. Credit: Robert F. Bukaty / AP

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David Farmer is a public affairs, political and media consultant in Portland, where he lives with his wife and two children.

When Maine voters approved Medicaid expansion at the ballot box in 2017 and Gov. Janet Mills implemented the expansion immediately after taking office, four things happened.

The first: Thousands of Maine people no longer had to choose between seeing a doctor when they got sick or hurt and putting food on the table.

Secondly, fewer people died.

A new study on medical debt, released this week by JAMA, found two other bits of important information. People in states that failed to expand Medicaid have more medical debt than people in states that immediately adopted expansion. And people in states that were slow to adopt expansion suffer more medical debt than people in states that immediately expanded coverage under the Affordable Care Act.

Maine’s history on Medicaid expansion is a story of political disappointment. Year after year, time after time, the Legislature did the responsible and compassionate thing and voted to expand access to high quality, affordable care.

And time after time, former Gov. Paul LePage blocked implementation. Even after voters passed expansion through a citizen’s initiative (disclosure: I worked on the campaign), the governor refused to follow the law and let people have access to health care.

It was bad policy, and it was unnecessarily cruel.

This year, thankfully, the Legislature and the governor made an additional improvement to Medicaid by ensuring that it will also cover dental care.

Here’s a breakdown of the numbers.

According to the Maine Department of Health and Human Services, Medicaid expansion has provided access to health care to nearly 78,000 Maine people through May 2021.

That translates into more than 15,000 people who have received treatment for substance abuse disorder. About 7,000 people have received treatment for diabetes and 7,400 people have been treated for hypertension. It’s also meant that 4,700 people have received care for colorectal cancer and 6,400 have received breast cancer screenings.

There’s no question that such coverage has helped to save lives.

The new research released this week examines the economic impact on people who gained coverage. The findings are intuitive.

Here’s how the New York Times described them: “Americans owe nearly twice as much medical debt as was previously known, and the amount owed has become increasingly concentrated in states that do not participate in the Affordable Care Act’s Medicaid expansion program.”

The bottom line is that the Affordable Care Act and Medicaid expansion have not only saved lives while bringing new federal dollars to states, but it has also improved the financial circumstances of thousands of low-income families, including families in Maine.

Taken together, Maine’s decision to expand Medicaid and provide health care and now, dental care, to more than 70,000 people may be two of the most consequential policy decisions for working families in Maine.

People are able to get the health care and, soon, the dental care that they need. They have less medical debt. And their lives are measurably better.

Now, as we read the headlines about the next race for governor, we see that former LePage — the person singularly responsible for blocking health care for more than 70,000 — is running again. This time he’s trying to “clean up” his act.

But the former governor has a record, and that record includes his decisions to keep Maine people from getting the health care they need. It includes a decision that leads to higher medical debt for working families. Fewer cancer screenings. Less treatment for substance use disorder. Less money for the state.

When she ran for governor, Mills promised she would expand Medicaid. She delivered on that promise and it’s made an incredible difference for families all across the state.

When you’re sick or if you get hurt, you should be able to get the help you need. Medicaid and its expansion delivers for Maine people.

David Farmer is a political and media consultant in Portland, where he lives with his wife and two children. He was senior adviser to Democrat Mike Michaud’s campaign for governor and a longtime journalist....