Is Maine's Medicaid lawsuit a harbinger for other anti-expansion governors?

Medicaid
Advocates in Maine are moving forward with a lawsuit against its current governor who refuses to act on a passed Medicaid expansion ballot initiative. (Getty/juststock)

Advocates in Maine are suing their governor for refusing to act on a successful Medicaid expansion ballot initiative, a legal battle that could be closely watched by other anti-expansion governors.

Maine Equal Justice Partners, along with several other groups, filed suit (PDF) on April 30 against Republican Gov. Paul LePage for standing in the way of a Medicaid expansion measure supported by almost 60% of Maine voters in a ballot initiative last November.

The governor's office was required to submit an application to ensure about half a billion dollars in annual federal funding for expansion by April 3, but LePage, who has vetoed previous expansion attempts, has refused to move the application forward.

Case Study

Across-the-Board Impact of an OB-GYN Hospitalist Program

A Denver facility saw across-the-board improvements in patient satisfaction, maternal quality metrics, decreased subsidy and increased service volume, thanks to the rollout of the first OB-GYN hospitalist program in the state.

Under state law, a successful ballot initiative can't be vetoed by the governor, which has led to the current standoff. The New England state's legal drama is the first of its kind, and it could catch the attention of officials and candidates in other states grappling with similar dynamics.

Advocates in several other reliably red states, like Idaho, are trying to move forward with Medicaid expansion initiatives this year, but its future governor will have a stronger political advantage than LePage.

RELATED: States have no regrets over Medicaid expansion, Brookings analyst says

Reclaim Idaho, a group that supports Medicaid expansion in the state, announced on April 30 that it turned in about 60,000 signatures to get the issue on the ballot this November, 7% more than required. And polling late last year showed public support at about 60% in Utah.

However, unlike Maine, Idaho's governor wouldn't be legally required to follow through with the ballot initiative, which has the same weight as a law passed in the state legislature. 

Idaho Gov. Butch Otter is not seeking reelection to a fourth term this November, and the Republican nomination—and general election favorite—is likely between U.S. Representative Raúl Labrador and Lieutenant Governor Brad Little, who Otter has endorsed.

RELATED: GOP governors up against the fence on Medicaid expansion, cuts

In a recent televised debate, Little, who has long opposed expansion, said he would "adhere to the will of the voters," likely signaling he would implement expansion if the ballot initiative is successful. Labrador, on the other hand, was more vague, and appeared to say he'd be open to overturning the initiative. A third candidate, businessman and retired physician Tommy Ahlquist, also gave an ambiguous response about the ballot's future.

While none of the candidates offered a hardline stance, Idaho's next governor might wait and see what happens in Maine before deciding whether or not to overturn the will of the people.

Suggested Articles

A report shows that Medicaid managed care can save significantly more on drugs on than traditional Medicaid. Here are highlights from the analysis.

Blue Cross Blue Shield of Michigan now has 14 participants in its Blueprint for Affordability program. Here's what that model entails.

A healthcare non-profit wants to build a “moonshot factory” to bring data science and precision health to remote villages in the developing world.