Voters in Maine elected overwhelmingly on Tuesday night to expand Medicaid coverage to nearly 70,000 uninsured citizens in a monumental referendum that would make the state the first to expand the health insurance program via the ballot box.

That is, unless Gov. Paul LePage has anything to do with it. The Maine state legislature has voted to expand Medicaid on five separate occasions, and each time, LePage has vetoed it.

Now, voters in the state have done the same, but in a statement Wednesday morning, LePage said he would block the expansion anyway.

“My administration will not implement Medicaid expansion until it has been fully funded by the legislature at the levels [Maine’s Department of Health and Human Services] has calculated,” his statement said.


While that almost sounds like LePage is leaving the door open, he adds that he won’t support it unless the legislature funds the expansion without increasing taxes or using the state’s rainy day fund.

Maine Medicaid expansion seems to not be a done deal. Here’s LePage’s statement. https://t.co/ggjofjQSsV pic.twitter.com/wPwtm8nkfY — Margot Sanger-Katz (@sangerkatz) November 8, 2017

But Maine’s constitution makes clear that, despite LePage’s resistance, the law will go into effect 45 days after the legislature convenes again next January.

According the state constitution, “any measure which entails expenditure in an amount in excess of available and unappropriated state funds shall remain inoperative until 45 days after the next convening of the Legislature in regular session.”

Screenshot of the state constitution via Brian Beutler

“The governor, despite what he may think or say, is not above the law or the constitution of the state,” David Farmer, a spokesperson for Mainers for Health Care, the group behind the ballot initiative, told ThinkProgress Wednesday morning. “He doesn’t get to pick and choose which laws he implements.”


Farmer explained that the way the initiative was structured, it would mean that, if the law simply went into effect 45 days after the legislature reconvenes next January, people should be able to enroll in coverage by mid-August of 2018. And, at that point, if LePage simply refuses to enact and enforce the law, the group will take action.

“Political games, partisan politics aside, the voters have spoken,” Farmer said. “We will do everything that we can to ensure that this law is implemented…. If that means that we need to go to court then we will go to court.”

The vote in Maine, which passed with nearly 60 percent of the vote, comes just weeks after another attempt by Republicans in the Senate to repeal and replace the Affordable Care Act. Time and time again, Sen. Susan Collins (R-ME) has been a pivotal vote against the repeal bills, citing concerns about Medicaid cuts.

Tuesday’s vote to expand Medicaid in Collins’ state is, among other things, a message to the senator that her constituents want her to keep it up.

“The reason [repeal and replace] failed is pretty straightforward,” Farmer said Wednesday. “Voters did not like it, they did not want it…. We put that question on the ballot and put it to the ultimate test.”

While Medicaid expansion passed the test in the ballot box, whether it will pass the LePage test is up in the air. The governor has a history of trying to block progressive ballot measures that demonstrate just how far he might be willing to take this.


Just last week, for instance, LePage vetoed a bill that would have implemented a marijuana legalization initiative that passed last year, claiming that it “required [him] to flout federal law.” (It didn’t.) Earlier this year, LePage also tried to block a referendum question that raised taxes on the wealthy to provide additional funding for schools. It ultimately led to a short government shutdown.