PORTLAND, Maine (AP) — Maine must use funds currently budgeted for health care spending and begin expanding Medicaid to its residents as voters demanded last year, a state judge said in a Wednesday ruling that the outgoing Republican governor said he would appeal.
Justice Michaela Murphy ruled Wednesday that Republican Gov. Paul LePage's administration has until Dec. 5 to adopt rules rolling out Medicaid expansion for eligible residents who applied in July. She also said Maine can fund its share of expansion costs using existing state funding lawmakers budgeted for health care spending.
Meanwhile, Democratic Gov.-elect Janet Mills, who is also the state's attorney general, has said she'll immediately expand Medicaid and praised Wednesday's ruling.
"If there is an appeal, it will shortly be moot," said her spokesman Scott Ogden in an email.
Nearly three out of five people voted in 2017 to expand Medicaid to 70,000 low-income residents. LePage vetoed five previous attempts to expand the health coverage.
The original law didn't include a funding source for Maine's share, and LePage has blocked expansion over his financial concerns.
Murphy's decision addresses questions at the heart of an ongoing battle over expansion. Her Wednesday decision finds that the LePage administration has "failed and refused to comply with" Maine's voter-approved Medicaid expansion law.
"The commissioner is certainly entitled to disagree with the policy behind MaineCare expansion, but the people have spoken and did so over a year ago," Murphy said, referring to the head of Maine's Department of Health and Human Services.
"A potential, future fiscal crisis, based only on projections that are now many months old, is not at all the same thing as a 'fiscal emergency' that could justify refusing to implement the expansion act."
Maine has enough existing Medicaid funds to cover expansion costs through May 2019, according to the Legislature's nonpartisan fiscal office.
But the LePage administration claims that the money could run out faster if enrollments exceed expectations. The governor has also argued that lawmakers must identify a new, long-term funding source like a hospital tax for Maine's expansion costs.
Murphy said it's up to lawmakers to figure out how to pay for Medicaid expansion if funds run out. Mills has said she will "absolutely" propose a plan to fund Maine's share.
"Although the governor may believe implementation to be unwise and disagree with the act as a matter of policy, he may not ignore the will of the people and refuse to take any action toward accomplishing the policy objectives of the act," Murphy wrote.
Medicaid expansion supporters cheered Wednesday's decision, and said other states have passed expansion without specifying how they'll fund their share.
"It's a tremendous victory, it's a great step forward," said Charlie Dingman, a lawyer for Maine Equal Justice Partners, which sued LePage's administration this spring for blocking the law.
LePage vetoed a bill this past summer to fund the first year of Maine's share of expansion through a budgetary surplus and a one-time tobacco settlement. The governor dismissed the bill as relying on "budgetary gimmicks," while lawmakers failed to override his veto.
LePage's administration is seeking what will likely amount to $525 million yearly for Medicaid expansion. He has urged federal regulators to reject a court-ordered Medicaid expansion plan, citing financial concerns.
