A ballot initiative will allow as many as 89,000 Maine residents to gain coverage.

Maine will become the 33rd state to expand Medicaid under the Affordable Care Act, expanding coverage to as many as 89,000 low-income residents.

The Associated Press and NBC News projected the victory late Tuesday.

Maine is the first state to expand Medicaid during the Trump administration, and also the first to do so via a ballot initiative rather than legislation. This offers a possible playbook for health care advocates in other states looking to extend coverage but stymied by political opposition.

Medicaid expansion actually has a fair amount of bipartisan support in Maine. Earlier this year, I wrote about a Republican state legislator named Tom Saviello who has repeatedly introduced bills to expand the Medicaid program.

“The people I represent need this,” he told me. “It’s as simple as that.”

The legislature had actually passed five separate bills to expand Medicaid prior to the ballot initiative. But Maine Gov. Paul LePage, a Republican, has vetoed all of them. Unsurprisingly, LePage had also been a vocal opponent of the Tuesday ballot initiative. Here’s what the governor said in a radio address last week:

This Medicaid expansion is not for children or the elderly. They are already covered by Medicaid.

This Medicaid expansion would give “free” health care to able-bodied adults who can work and contribute to their own health insurance costs.

I’ve said it before: “Free” is very expensive to somebody. This time, it will cost Maine taxpayers up to $500 million in the next five years. Maine learned this the hard way when it expanded Medicaid in 2002.

LePage was citing numbers from Maine Heritage Policy Center, a conservative think tank in the state that has estimated that “when fully implemented” the state will need to spend Read More Here