Last November, Mainers overwhelmingly voted in favor of a ballot measure that would expand Medicaid. Until now, the state’s firebrand Republican Governor Paul LePage has successfully blocked the expansion by simply ignoring his constituents and refusing to move forward on its implementation. The standoff may soon have to end: On Monday, a group of health-care advocates in the state sued LePage, saying his foot-dragging is directly harming the 80,000 low-income people who were supposed to be eligible to enroll in Medicaid this year.
Because LePage is term-limited and cannot be reelected this fall, his stonewalling can only delay implementation of the Medicaid expansion for so long. But already his defiance is inspiring other anti-ACA Republicans to follow suit.
In Idaho, where pro-Medicaid advocates announced Monday that they’ve surpassed the amount of required signatures to put expansion on the ballot this November, a far-right candidate for governor has already vowed to pull a LePage if it passes.
In a GOP gubernatorial primary debate last week, Rep. Raul Labrador (R-ID) said he “would look at all the options” for overturning the initiative to expand Medicaid to cover 62,000 more people in the state. His opponent, Lt. Gov. Brad Little, disagreed, promising instead to “adhere to the will of the voters.”
Supporters of the Medicaid expansion insist they will prevail both at the ballot box and in the courts, but Maine’s experience with a hostile governor serves as a cautionary tale for advocates working to gather signatures for expansion initiatives in Idaho, Nebraska and Utah.
Meanwhile, the uproar over Trump’s HHS’ suggestion that it may force Native American tribes to comply with Medicaid work requirements continues. Ten senators — nine Democrats and Sen. Lisa Murkowski (R-AK) — wrote to the agency expressing alarm at HHS’ position that exempting tribes from the requirements would be giving them an illegal race-based privilege. “Tribes are not a racial group but rather political communities,” the senators wrote. “The views expressed fail to recognize the unique legal status of Indian tribes and their members under federal law, the U.S. Constitution, treaties, and the federal trust relationship.”
As more states with Native American tribal populations seek permission to implement Medicaid work requirements, including Ohio, Michigan, Arizona, this is likely to become a major legal fight in the months ahead. Ohio, which just submitted its work-requirements proposal Monday night, estimates that 18,000 people could be kicked off Medicaid. Health advocates say the actual number’s much higher, and are exploring a lawsuit.
Finally, a new study from the Commonwealth Fund released Tuesday finds that Trump administration policies are driving up the number of uninsured Americans. About four million working-age people have lost insurance coverage since 2016, the group reports, citing a laundry list of federal actions exacerbating the trend, including “deep cuts in advertising and outreach during the marketplace open-enrollment periods, a shorter open enrollment period,” the repeal of the individual mandate, Medicaid work requirements, and “recent actions to increase the availability of insurance policies that don’t comply with ACA minimum benefit standards.”
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