Janet Mills sits in a Portland courtroom as the fate of Medicaid expansion is debated.
In this 2018 file photo, then-Gov.-elect Janet Mills makes an appearance in the gallery of a Portland courtroom where the fate of Medicaid expansion was being debated. Credit: Troy R. Bennett / BDN

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When the COVID-19 pandemic hit Maine, it could have gone a lot worse. Older folks are more vulnerable to the virus, and our state has the oldest population in the country. Yet Maine’s death toll has been among the lowest, with deaths per million approximately half that of Florida, the fifth oldest state.

Gov. Janet Mills deserves a good deal of credit for how well Maine weathered this deadly disease. Sure, she’s not the only leader who mattered. Maine Center for Disease Control and Prevention Director Nirav Shah has done an excellent job managing the pandemic response and communicating with the public. So many health providers did outreach, administered vaccinations and cared for the sick.

But Mils has done quite a lot. She tackled the damage former Gov. Paul LePage caused in undermining Maine’s public health system. On her first day in office, she expanded Medicaid, reversing LePage’s decisions that kept tens of thousands of Mainers from getting health coverage.

As scholars Pamela Herd and Donald P. Moynihan observe, states that wouldn’t create a state-run health insurance marketplace made it harder for people to get covered. LePage refused to create one. Working with the Legislature, Mills started one.

Mills also backed policies making health care more affordable to children, women who had children, rural Mainers, people needing dental care, those buying their own coverage and more.

Past performance tells voters a lot about what candidates would do if they got elected. And that’s good because LePage and some in his party have been incredibly fuzzy about the health policies they’d pursue.

Take Medicaid expansion, which now covers more than 93,000 Mainers.

Whether to expand Medicaid was a huge issue when LePage was governor. While the Affordable Care Act originally required states to increase coverage to low-income people, in 2012 the Supreme Court decided states could say no.

The Legislature passed Medicaid expansion multiple times. LePage repeatedly vetoed it.

When Maine people put a provision to expand Medicaid on the ballot and backed it in a roughly 59 percent to 41 percent landslide, LePage refused to implement it.

So you might think that LePage would be clear about what he’d do going forward.

Yet, when asked this February if he’d roll back the expansion now covering more than 90,000 Mainers, LePage was vague, voicing support for work rules and saying, “I’m not going to repeal anything that is good for Maine people.”

Oddly enough, virtually the same language was used by LePage’s campaign about another health matter. As the BDN’s Caitlin Andrews reported, when queried about public health funding that would help Maine deal with another pandemic, LePage campaign spokesperson Brent Littlefield said LePage “is not looking to repeal anything that is good for Maine people.”

Of course, what’s “good for Maine people” is not a plan, detailed or otherwise. It’s just a statement that LePage would do what he thinks is good for Mainers — whether or not Mainers agree.

Most Americans think access to legal abortion is good. Yet, as the Supreme Court appears to be poised to overrule Roe v. Wade, LePage hasn’t shared what specific restrictions on abortion he’d back if he was elected.

LePage is not the only Maine Republican who hasn’t offered clear health policy positions with voters.

Another example is former state senator Brian Langley, a Republican who is running against Democratic Rep. Nicole Grohoski in a June 14 special election in Senate District 7. The district encompasses most of Hancock County, a county in which more than 3,200 people now benefit from expanding Medicaid. When in office, Langley rejected Medicaid expansion several times. In 2013, Langley co-sponsored an expansion bill but voted against it after Republicans organized a lobbying effort. Langley will not be participating in a usual candidate forum and, unlike Grohoski, doesn’t address health policy on his campaign website.

Luckily whatever the issue — and policies affecting public health and health coverage matter a lot — previous votes and actions tell voters a lot about what candidates would do if they got elected. So even when politicians are vague or unresponsive, voters can and should study their histories on health policy.

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Amy Fried, Opinion columnist

Amy Fried has written about the media and politics, women in politics, Maine and American political culture, and political activism, and works to create change through the Rising Tide Center. A political...