Gov. Paul LePage (R-ME) will leave office in January — but not before using his final few months in the governor’s mansion to resisting providing health care to an additional 70,000 low-income Mainers.

A Maine judge ordered LePage this week to follow through on expanding the Medicaid program in the state, setting a December 5 deadline for the state to make meaningful progress on setting up the health care expansion.

It’s the latest development in a protracted legal battle over the policy, which was approved by voters via ballot referendum last year but which LePage has stubbornly slow-walked, thwarting the will of Maine voters.

Ever since a 2012 Supreme Court ruling held that the Affordable Care Act’s Medicaid expansion should be determined by each state, LePage has stood in the way of extending the program to additional Mainers.


LePage was one of about two dozen GOP governors who refused to accept Obamacare’s federal funding to implement the expansion in the aftermath of the 2012 ruling, leaving more than five million Americans with a coverage gap. (Thanks to expansion efforts in some of those states, that gap has since narrowed to about two million people.)

The Maine legislature put forth five different bills seeking to expand Medicaid; LePage vetoed each one. Then, Medicaid expansion advocates tried a different tact — bypassing the legislature to put the issue on the 2017 ballot, posing the question of Medicaid expansion directly to Maine voters.

Nearly 60 percent of voters endorsed the measure, making Maine the first state in the country to approve Obamacare’s Medicaid expansion through a ballot initiative.

Nonetheless, LePage has continued to block the policy, refusing to take the necessary administrative steps to expand the program and vetoing legislation that would have appropriated funding for the expansion.


In her opinion handed down Wednesday, Superior Court Justice Michaela Murphy wrote that LePage cannot continue to sabotage Medicaid expansion, and detailed several steps that Maine must take in order to implement the law.

“Although the Governor may believe implementation to be unwise and disagree with the Act as a matter of policy, he may not ignore the will of the people and refuse to take any action toward accomplishing the policy objectives of the Act,” Murphy wrote.

The court decision hasn’t changed LePage’s stance on the subject, however. LePage’s office told the Press Herald that the governor plans to appeal.

Though Murphy’s opinion didn’t mince words, it’s not entirely surprising that the judge hasn’t managed to sway the outgoing governor. In July, LePage said that he would rather go to jail than participate in implementing the expansion.

“I will go to jail before I put the state in red ink,” the governor said during a radio appearance, referring to his concerns about Medicaid expansion’s potential impact on the state budget. “And if the court tells me I have to do it, then we’re going to be going to jail.”


Regardless of how LePage uses his final months in office, the Medicaid expansion stand-off in the state will soon come to an end. In January, LePage will be replaced by incoming governor Janet Mills, a Democrat and former attorney general who has vowed to make implementing Medicaid expansion her top priority.

Maine’s experience tussling over Medicaid expansion has also sparked somewhat of a trend. Inspired by the successful referendum in Maine, health care advocates in Idaho, Nebraska, and Utah worked to get Medicaid expansion initiatives on their own ballots in 2018 — and all three passed on Election Day.