Newly sworn in Gov. Janet Mills, a Democrat who campaigned on broadening access to health insurance, used her first executive order to direct the Maine Department of Health and Human Services to begin implementation of Medicaid expansion. The effort had been repeatedly blocked by former Gov. Paul LePage, a Republican, who cited the financial burden. He stuck with his refusal to make the change even though the state's Supreme Court ruled that the expansion's effective date was July 2, 2018. "Expanding health care and lowering the cost for Maine people and small businesses is a top priority of my administration, and I look forward to working with the legislature to achieve that goal," Mills said.The new governor also promised to work with the legislature, which is now controlled by Democrats, to make expansion financially sustainable. More than 70,000 Mainers are expected to gain coverage through expansion.Mills last month named Jeanne Lambrew, who served as a health policy expert in the Obama and Clinton administrations, as commissioner of Maine's Department of Health and Human Services. Not mentioned in the order was the Trump administration's recent approval of LePage's request to require certain Medicaid recipients to work at least 20 hours a week and pay premiums of up to 5% of their monthly household income. Those who don't comply will lose their benefits. Implementation can't begin until after July 1, 2019, according to federal officials.The governor is reviewing the waiver, said her spokesman, Scott Ogden, noting that she prefers incentives to work rather than mandates."Making sure people are healthy, of course, is the first step in making them eligible for work," Ogden said.Medicaid expansion's success in Maine emboldened grassroots campaigns in Idaho, Nebraska and Utah. Voters approved measures in each of these deep-red states in November.

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