Asylum seekers arrive with their belongings at the Portland Expo Center, Monday, April 10, 2023. Credit: Robert F. Bukaty / AP

AUGUSTA, Maine — The Maine House of Representatives passed Monday a top Democrat’s proposal to expand state health coverage to more undocumented immigrants.

The bill from House Speaker Rachel Talbot Ross, D-Portland, would allow low-income, non-U.S. citizens, including undocumented residents, refugees and asylum seekers, who are 21 and older to qualify for MaineCare, the state’s Medicaid program.

The House voted 78-61 to pass the bill Monday. It now goes to the Senate. Gov. Janet Mills has not commented on this year’s proposal, which had sat in the House without a vote since April. A similar measure died in 2022, with advocates saying too many lawmakers were hesitant to support expanded health care for immigrants ahead of the November election.

This year, the debate over how to best accommodate hundreds of asylum seekers in cities like Portland and Sanford has picked up steam and crisscrossed the issue of Maine lacking enough affordable housing.

The Department of Health and Human Services would have to adopt rules on the expanded program by July 1, 2024, under the bill. A fiscal note said about $13.7 million is needed for the expansion in the fiscal year beginning in July, growing to about $17 million in 2025 and 2026.

It is unclear how many people would qualify for the expansion, but MaineCare eligibility rules say a single adult cannot make more than $20,124 per year. For a family of four, the limit is $41,400.

The majority of people who would gain coverage through the bill have “lawful presence,” including green card holders, Violence Against Women Act self-petitioners who have been in the country for less than five years and asylum seekers with pending applications, Alex Carter, policy advocate at Maine Equal Justice, which supports the bill, said. Refugees and asylees, who have approved asylum cases, are already eligible for Medicaid, Carter noted.

As part of a 2021 state budget deal, people who are not U.S. citizens but who are pregnant or younger than 21 can obtain MaineCare coverage.

That reversed a 2011 move from former Gov. Paul LePage and Republicans in control of the Legislature at the time, which made about 500 immigrants who had been U.S. residents for less than five years ineligible for MaineCare except for emergency benefits. Lawmakers viewed the change to a chronically over-budget program as necessary during tough economic times.

“Exclusions based on immigration statuses are unfair (and) are shortsighted,” Rep. Deqa Dhalac, D-South Portland, who joined Rep. Mana Abdi, D-Lewiston, last year in becoming the first Somali Americans to serve in the Legislature.

Mills has said she is proposing millions in her budget for affordable housing and municipal aid to help Maine cities better assist hundreds of asylum seekers who arrived this year while also asking Congress to let the newcomers work sooner. Under federal law, asylum seekers must wait at least six months before seeking work.

Democrats and an “All Means All” coalition of progressive groups supporting the bill have argued every person has a right to health care and that Maine needs more workers to fill a labor shortage as the state’s median age tops the nation.

Republican lawmakers have said Maine’s health system is already strained, with Rep. Ann Fredericks, R-Sanford, arguing Monday the expansion could bring it to a “total collapse.”

Advocates, however, pushed back on that and other GOP claims that the expansion would lead to “busloads” of more immigrants arriving in the state and cited research showing little evidence exists for that happening in states that expanded health care coverage to more immigrants.

Billy Kobin is a politics reporter who joined the Bangor Daily News in 2023. He grew up in Wisconsin and previously worked at The Indianapolis Star and The Courier Journal (Louisville, Ky.) after graduating...