Maine Question 2, 2017

Question 2: Citizen Initiative
An Act To Enhance Access to Affordable Health Care
Source: Maine Secretary of State[1]

Maine Question 2, formally titled "An Act To Enhance Access to Affordable Health Care", is a citizen-initiated ballot measure that has qualified for the November 7, 2017 statewide ballot. It seeks to expand Medicaid eligibility under the terms of the Affordable Care Act, something which has been vetoed six times by Maine Gov. Paul LePage.

Unofficial results have the referendum passing with 59% of the vote. Gov. LePage has stated that he will not implement the expansion unless it is funded by the Legislature in a way that meets his criteria, although a state court has ordered his administration to carry it out.

Background

Expanded eligibility for the Medicaid program, called MaineCare in Maine, was a provision of the Affordable Care Act signed into law by President Barack Obama on March 23, 2010.[2] The expansion was originally required of states as a condition of all federal Medicaid funding, but the United States Supreme Court ruled in National Federation of Independent Business v. Sebelius that such expansion was optional for states.[3]

Maine Republican Gov. Paul LePage has long been critical of the eligibility requirements for MaineCare, feeling that it was too easy to qualify for as it existed when he took office in 2010.[4] He was a staunch opponent of the Affordable Care Act, believing it to be unconstitutional and taking freedom from citizens.[5] LePage vetoed six efforts to expand MaineCare eligibility[6] and on one occasion called efforts by the Maine Legislature to write an expansion bill that would garner bipartisan support as having "no compassion".[7]

Supporters of expansion, led by Maine Equal Justice Partners, announced on October 12, 2016 their intent to launch a petition drive to put the issue to voters in a referendum, which the Governor cannot veto if passed. LePage's spokesperson criticized the effort as "another attempt by liberals to pass welfare expansion".[8]

Maine Secretary of State Matthew Dunlap announced on February 21, 2017, that supporters of the measure submitted over 66,000 verified signatures, far above the 61,123 required to place a measure on the ballot.[6]

The question that appeared on petition forms was "Do you want Maine to provide health insurance through Medicaid for qualified adults under the age of 65 with incomes at or below 138 percent of the federal poverty line?". During the comment period before the question's wording was finalized, several Republican legislators disputed the inclusion of the word "insurance" in the question, stating that in their view MaineCare benefits are not insurance, but welfare benefits. As such, in their view it would not meet the Maine Constitution's requirement that referendum questions be "simple, clear, concise, and direct". They further noted that the word insurance does not appear in the proposed referendum itself. Supporters defended the use of "insurance" as MaineCare does not provide cash to recipients, but pays providers of medical services directly.[9] At the end of the comment period, Secretary Dunlap announced that the final wording of the question would replace the word "insurance" with "coverage". Representatives of both sides of the issue announced their support of the decision.[10]

Campaign

Endorsements

Supporters

Individuals
Organizations
Yes on 2
  • American Association of University Women (AAUW) Maine Chapter[11]
  • American College of Physicians - Maine Chapter[11]
  • Alliance for Addiction and Mental Health Services[11]
  • Alliance for Maine Women[11]
  • Congolese Community of Maine[11]
  • Congregation Bet Ha'am[11]
  • Consumers for Affordable Health Care[11]
  • Daily Kos[11]
  • Eastern Maine Labor Council[11]
  • Equality Maine[11]
  • First Parish Portland Unitarian Universalist[11]
  • Friends (Quakers) Committee on Maine Public Policy[11]
  • Kennebec Valley Community Action Program[11]
  • League of Women Voters of Maine[11]
  • Maine AFL-CIO[11]
  • Maine Association of Interdependent Neighborhoods[11]
  • Maine Children's Alliance[11]
  • Maine Coalition to End Domestic Violence[11]
  • Maine Community Action Association[11]
  • Maine Council of Churches[11]
  • Maine Dental Hygenists Association[11]
  • Maine Family Planning[11]
  • Maine Hospital Association[13]
  • Maine Nurse Practitioner Association[11]
  • Maine Primary Care Association [11]
  • Maine Providers Standing Up for Healthcare[11]
  • Maine Public Health Association[11]
  • Maine Small Business Coalition[11]
  • Maine State Nurses Association[11]
  • Maine Women's Lobby[11]
  • Maranacook Family Health Care[11]
  • MSEA-SEIU Local 198[11]
  • National Alliance on Mental Illness (NAMI) Maine[11]
  • National Association of Social Workers (NASW) Maine Chapter[11]
  • National Multiple Sclerosis Society, Greater New England Chapter[11]
  • New Mainers Public Health Initiative[11]
  • Northeast Occupational Exchange[11]
  • Penquis Community Action Program[11]
  • Shalom House, Inc.[11]
  • Southern Maine Democratic Socialists of America[11]
  • The Opportunity Alliance[11]
  • United Way of Greater Portland[11]
  • Waldo Community Action Partners[11]
  • YWCA Central Maine[11]
Media

Opponents

Results

Unofficial results as of election night have the referendum passing with 59% support to 41% in opposition.[17]

Gov. LePage has stated that he will not implement the expansion unless the Legislature funds it without a tax increase or using money from the state Rainy Day Fund. There is also disagreement as to how much money the expansion will actually cost, with different estimates from Maine DHHS, the Legislature, and supporters who call those estimates flawed. Republican candidates for governor Mary Mayhew and Kenneth Fredette (who is also House Minority Leader) are critical of the expansion, stating that Mainers did not fully consider the costs involved or taxes needed to pay for it. Democrats called for the law to be implemented and stated that they "will not give an inch in this fight", although they cannot provide funding on their own. The law can remain on the books even if not funded, and it may be an issue in the 2018 elections.[18]

Supporters of expansion sued the LePage administration on April 30, 2018 to force the expansion to be implemented. Judge Michaela Murphy ruled on June 4, 2018 that Maine Department of Health and Human Services Commissioner Ricker Hamilton must submit a plan for expansion as the law requires by June 11 so that MaineCare can start accepting newly eligible applicants on July 2. Lawyers for supporters argued that MaineCare has sufficient funds already for the current fiscal year, and there are also $140 million in unallocated funds elsewhere in the budget if necessary.[19] LePage has said he would rather go to jail than implement the expansion without a funding mechanism that meets his criteria. [20]

References

  1. ↑ "Citizens Initiatives & People's Veto". Maine Department of Secretary of State.
  2. ↑ Stolberg, Sheryl; Pear, Robert (March 23, 2010). "Obama Signs Health Care Overhaul Bill, With a Flourish". The New York Times. Retrieved March 24, 2010.
  3. ↑ "Analysis: U.S. Supreme Court Upholds the Affordable Care Act: Roberts Rules?". The National Law Review. von Briesen & Roper, S.C. June 29, 2012. Retrieved July 2, 2012.
  4. ↑ "Paul Lepage Profile – Your Vote 2010". Archived from the original on December 31, 2010. MPBN. Retrieved October 28, 2010
  5. ↑ "LePage calls Obamacare an expensive stripping away of freedom, says IRS is 'new Gestapo'". Bangor Daily News. July 7, 2012. Retrieved July 7, 2012.
  6. 1 2 "Medicaid expansion referendum headed to Maine ballot". Bangor Daily News. February 21, 2017. Retrieved March 3, 2017.
  7. ↑ "LePage blasts Legislature's tilt toward Medicaid expansion". Kennebec Journal. January 17, 2014. Retrieved January 17, 2014.
  8. ↑ "Group will launch signature drive for Medicaid expansion in Maine". Portland Press Herald. October 12, 2016. Retrieved September 9, 2017.
  9. ↑ "Hawke joins four others requesting referendum wording change". Boothbay Register. August 23, 2017. Retrieved September 9, 2017.
  10. ↑ "State alters wording of ballot questions on Medicaid expansion, York casino". Portland Press Herald. September 7, 2017. Retrieved September 9, 2017.
  11. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 "Yes on 2 Endorsers". Mainers for Health Care. Retrieved October 16, 2017.
  12. ↑ "SEN. GEORGE MITCHELL ENDORSES QUESTION 2". Mainers for Health Care. September 28, 2017. Retrieved October 11, 2017.
  13. 1 2 "Maine Hospital Association Supports Ballot Measure To Expand Medicaid". MPBN. September 29, 2017. Retrieved September 30, 2017.
  14. ↑ "Yes on Question 2: Medicaid expansion will benefit Maine in many ways". Bangor Daily news. October 23, 2017. Retrieved November 1, 2017.
  15. ↑ "Our View: Vote yes on Question 2: It's a good deal for Maine". Portland Press Herald. October 22, 2017. Retrieved October 22, 2017.
  16. 1 2 "DHHS: Medicaid Expansion Initiative Would Increase Taxes, Take Money Away From Schools and Jeopardize State's Commitment to Our Disabled and Elderly". Maine DHHS. February 22, 2017. Retrieved October 1, 2017.
  17. ↑ "Maine voters back Medicaid expansion". Bangor Daily news. November 7, 2017. Retrieved November 9, 2017.
  18. ↑ "What's next for Medicaid expansion as LePage and Democrats dig in". Bangor Daily news. November 8, 2017. Retrieved November 9, 2017.
  19. ↑ "LePage administration must follow voter-approved law, put Medicaid expansion in motion, court rules". Kennebec Journal. June 4, 2018. Retrieved June 5, 2018.
  20. ↑ "LePage Says He'd Rather Go To Jail Than Expand Medicaid". MPBN. July 12, 2018. Retrieved July 12, 2018.
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