Patrick Strawbridge, an attorney representing the Maine Department of Health and Human Services against a lawsuit over the lack of expansion of Medicaid in the state, speaks with reporters outside the Cumberland County Courthouse Thursday morning after oral arguments in the case. Voters statewide approved the expansion of the program in November 2017. Credit: Jake Bleiberg

PORTLAND, Maine — A state court heard arguments Thursday in a lawsuit aimed at compelling state government to enact a Medicaid expansion law that voters approved last year.

In 2017, Maine became the first state to expand the program at the ballot box, but its implementation was delayed by Republican Gov. Paul LePage, who stalled it for months while imploring the Legislature to fund the program on his terms.

Lawmakers ended the legislative session without approving a funding package and, last month, a progressive anti-poverty group sued the state in an effort to force it to begin expanding the government-funded health insurance program for low-income and disabled people.

During oral arguments Thursday morning, a lawyer for Maine Equal Justice Partners framed the lawsuit as a narrow question of the executive branch following the law. But an attorney for the Maine Department of Health and Human Services argued that it raises broad constitutional issues and asked the judicial branch to weigh in on funding questions reserved for the Legislature.

[Advocates take Maine Medicaid expansion fight with LePage to court]

Under the voter-approved law, the state was supposed to have sent an expansion plan to the U.S. Department of Health and Human Services by April 3. But the deadline came and went, and advocates contend that violates the law intended to expand coverage to an estimated 70,000 Mainers with incomes between 101 percent and 138 percent of the federal poverty level.

A lawyer for Maine Equal Justice Partners and the other parties to the case made that argument Thursday, asking the court to order the LePage administration to submit an expansion plan.

“Tell the commissioner he has to comply with the law,” said James Kilbreth, of Drummond Woodsum in Portland. “Submitting that two-page document is not a big ticket item.”

But a private attorney representing Health and Human Services Commissioner Ricker Hamilton told Justice Michaela Murphy that implementing the program is a massive financial commitment and the department cannot act without funding from lawmakers.

“We have a duty to execute unless it is not funded and this is a question of tens of millions if not hundreds of millions in funding,” said Patrick Strawbridge, a Boston-based lawyer with the firm Consovoy McCarthy. “The commissioner cannot do anything until there’s a substantial appropriation.”

Strawbridge has represented LePage in cases where Maine Attorney General Janet Mills, a Democrat running for governor, has refused to have her staff represent the governor.

[Maine voters back Medicaid expansion]

Murphy said that she clearly does not have authority to command lawmakers to fund the program, but the two attorneys disagreed on whether ordering the submission of a expansion plan would entail doing so. The judge reserved her ruling for a later date, but said she intends to issue it as soon as possible.

The case comes as the latest maneuver in Maine’s long political fight over expanding Medicaid under the Affordable Care Act, which will likely continue to be a live issue as the gubernatorial campaign heats up.

LePage has five times vetoed Medicaid expansion efforts passed by the Legislature, and Murphy’s decision is likely to be appealed to state’s highest court regardless of which argument she accepts.

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