In this Tuesday, Nov. 7, 2017, file photo supporters of Medicaid expansion celebrate their victory, in Portland, Maine. The credit rating agency Moody's Investors Service says Maine voters' decision to expand Medicaid might make it more difficult for the state to keep its budget balanced. Voters decided they wanted Maine to expand Medicaid to some 70,000 citizens in a public referendum on Tuesday. Credit: Robert F. Bukaty | AP

One of the nation’s most consequential electoral victories happened this month in Maine. Our state became the first to expand Medicaid during the Trump administration and the first to do so by a vote of the people — a clear affirmation of the goals of the Affordable Care Act and the establishment of health care as a right.

After years of the Maine Legislature voting to approve Medicaid expansion only to be vetoed five times by Gov. Paul LePage, nearly 60 percent of Mainers voted to reject the governor’s hostile opposition to expanding health care access to 80,000 people. Like 31 states and the District of Columbia before us, many of which were led by Republican governors, Maine decisively chose to make health care coverage more accessible than ever before.

Gov. LePage, however, has pledged to do everything in his power to block implementation of Medicaid expansion. If he follows through on this threat, he will not only be opposing the people of Maine but also breaking the law.

Medicaid expansion was intended to be a central pillar of the Affordable Care Act when it became law more than seven years ago. It was designed to ensure people whose incomes were too low to qualify for federal health care subsidies had options to stay connected to care.

But while upholding the constitutionality of the Affordable Care Act, the Supreme Court ruled in 2012 that states could choose whether to accept federal funding to expand Medicaid. This left the health care of millions of Americans, and 80,000 in Maine, up to the ideological whims of those determined to undermine the Affordable Care Act.

Gov. LePage has called Medicaid expansion an “experiment.” Yet in the dozens of other states that have already done so, millions of Americans have benefited. Medicaid expansion has allowed low-income people to get covered, reduced uncompensated care for providers and costs have grown more slowly for people in the individual market. And make no mistake, Mainers have been subsidizing this progress in health outcomes and financial security through our federal taxes — without seeing any of the benefits ourselves.

Medicaid expansion in Maine will help those making as little as $16,000 a year afford health coverage and hold down premiums for others. Working families will finally have access to the coverage they need, and those struggling with addiction will have more options for treatment.

The economic benefits can’t be overlooked, either. Gov. LePage’s repeated vetoes of Medicaid expansion have cost Maine hundreds of millions in lost federal funding. Accessing those federal resources could help create 6,000 jobs, including 4,000 in the health care sector.

By any measure, this is a life-changing proposal for tens of thousands of our friends and neighbors in Maine, as well as being sound economic policy.

So, why then would Gov. LePage oppose it? Unfortunately, Medicaid expansion is just one more example of how he has often reacted when the conversation is focused on meeting Mainers’ basic needs. For too long, we’ve called it a difference of opinion or an ideological divide, anything but what it is: nonsensical, uncooperative and out of touch.

Whether he’d like to or not, Gov. LePage can’t veto the voters this time. The Maine Constitution says that the Medicaid expansion initiative will take effect 45 days after the Legislature reconvenes in January. Within 90 days of taking effect, the initiative requires the state to file a state plan amendment with federal officials. Within 180 days, the state is required to start covering Mainers.

The Maine people have unmistakably used their voice and their vote to support health care access. I plan to do everything in my power to ensure smooth implementation on the federal side. Gov. LePage should take the opportunity to do the same at the state level.

Maine is moving forward with or without him.

Chellie Pingree represents Maine’s 1st Congressional District in the U.S. House of Representatives. She serves on the Appropriations Committee.

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