Skip to content Skip to footer

Splitting Trump’s Base through a Fight Over Medicaid in Maine

Article published:
People standing in front of a banner that says Mainers for Health Care

Maine People’s Alliance (MPA) is a statewide organization with a significant base: 32,000 members. One in 17 households in the state have been actively connected with the organization in one way or another: receiving its newsletters, giving money or coming to meeting. MPA recently won a resounding victory, winning Medicaid expansion through a ballot initiative that received 60% of the popular vote, including in districts that had voted for Trump in 2016. Here, Organizing Upgrade editor, Harmony Goldberg, interviews Maine People’s Alliance’s Director, Jesse Graham, who offers reflections on how they won that victory and how they are using it to build power and shift politics in the state.  

Can you give me a brief overview about Maine People’s Alliance and the political context in Maine? 

Maine People’s Alliance has been a multi-issue organization working on affordable housing, getting money out of politics, fair taxes and in 2016 we won an increase in Maine’s minimum wage.   Health care has been a really big part of our organization for a long time. We’ve found that – even though it’s not easy to win big victories in health care – it’s an issue that really resonates to a lot of people.  Health care is an issue that deeply concerns many of our members, and it is an issue where it is easy for them to connect with others.  We’ve worked for single payer in the past, and we were part of the effort to fight for and defend Obamacare.  We have been trying to win Medicaid expansion through the state legislature for years.  We passed legislation to expand Medicaid five times, only to have it vetoed again and again by our right-wing Governor LePage, who describes himself as having been “Trump before Trump.” Many groups have continued to try to move policies legislatively under LePage, but they can’t get them done. So we decided to try a different method: taking it to a ballot initiative. If we won at the ballot, the governor couldn’t legally block Medicaid expansion from happening.  We are lucky to have the ballot initiative mechanism in Maine and the infrastructure to use it.

Tell me the story of your successful campaign to expand Medicaid in Maine.

We’ve run successful ballot initiative campaigns on different issues over the years, which I think demonstrate the power of this method.  We build the capacity we need to win one fight, and then we use the organizing capacity that we’ve built in that campaign to immediately lay the groundwork for the next campaign to unfold. Between 2014 and 2016, we ran a successful ballot campaign to raise the minimum wage in the state. We had to build a large volunteer base to win that fight, and we turned all of those minimum wage volunteers out on Election Day to collect signatures to put Medicaid expansion on the ballot this year. Election Day is a great time and a place to gather signatures: everyone who’s there is a registered voter, and it’s good to grab people when they’re thinking about political issues and democracy. Last year, we were able to collect all of the 60,000 signatures that we needed to get it on the ballot on that single day.

Many conservative leaders fought it, lead by Governor LePage. They tried their standard strategy of racist messaging. They tried to paint Medicaid as a “welfare” program, with all the normal racist implications, but that didn’t take hold.  Their racist messaging wasn’t working. They made outrageous claims about Medicaid expansion shutting down nursing homes or driving up the cost of hunting licenses. They were way off-base in this campaign.

Your inbox needs more left. Sign up for our newsletter.

And this year on Election Day, 60% of Maine voters supported the initiative to expand Medicaid. So we won Medicaid expansion at the ballot box, and now 70,000 people in Maine will get health insurance coverage.  That’s a big deal for Mainers. We won all over the state, including in lots of places where Trump won in 2016 and where LePage has been winning for years.  When we were collecting the signatures to get Medicaid expansion on the ballot in 2016, there were definitely people in “Make America Great Again” hats who were coming up to us and signing the petition. That shows that health care is an issues that can cut across political persuasions.

What’s happening now?  Your Governor is trying to block the expansion on Medicaid?

Yes, LePage has been threatening to block the expansion, even thought there’s very little that he can actually do. He does have some push and pull around how it gets funded, but, in the short term, not that much is actually needed.  People will be able to sign up soon, but everyone won’t enroll at once. So it will take time for the costs to develop. Then, the real fight over funding will come in the next bi-annual budget, in 2019, after LePage is already out of office.  And the truth is that the funding won’t set Maine back; Medicaid expansion is actually a great deal for Maine economically. The state has to come up with $50 million to fund the program, but the federal government reimburses 90% of the costs, so they’ll be putting $500 million in the program.  So in addition to winning health care access for 70,000 people, we also won a huge economic boon for the state: a half billion dollars a year. LePage has some diehard conservative voters, but even they understand that this will create between 3,000 and 6000 new jobs in Maine. This is a small state, so when you create 3,000 jobs, that’s a big deal for the state as a whole. That makes Medicaid expansion a cross-cutting issue that has some bipartisan support.

But LePage is still going to make it a fight.  He had a press release ready to go the night of the election saying he would block the expansion. It’s not the smartest move for him or for the Republicans in the state.  He will probably lose some Republican House seats, in districts where we’re already planning canvassing and digital work.  Basically, there are a number of representatives who have voted against expansion in the past, but the voters in their districts approved it overwhelmingly.  If they are really going to spend 2018 – which is a big election years – arguing about why people should have less healthcare while we’re arguing that more people should have it, I say, “Go right ahead.” That’s a fight that we’re up to having. If their talking points are all about health care, that’s great for us. If that’s how things play out over the next six months, then we won’t just end up winning in traditionally Democratic districts, but also in Republican districts. They’ll get cut if they stick their necks out on this, when 60% of the electorate voted for it.

What’s next For Maine People’s Alliance?

We’ve found that a broader frame of “care” is a cross-cutting issue that resonates across partisan lines. This year on Election Day, we were collecting signatures at the polls about universal senior care/universal home care. That is, we’re going to run a ballot initiative about providing an in-home care benefit to seniors and to people with disabilities. We found that it was overwhelmingly popular. Tons of people were signing the petition, and it was unlike anything I’ve ever seen.  People were telling stories while they were signing the petition, crying and sharing stories.  It’s a very heartfelt connection to the issue, much more than even Medicaid expansion or raising the minimum wage. Talking about their grandparents and end-of-life care really pulls at people’s heartstrings.  People were lining up to sign to get this on next year’s ballot.  After a 30- or 60-second conversation, they were then actively recruiting friends and neighbors to come over to sign it, too.  I think the idea of care – including childcare – is a powerful issue that cuts across traditional lines.  The idea that people are caring for people who are sick and at the end of their lives, while they are also caring for kids…people really feel that struggle.

What lessons can organizers in other states learn from your victory?

There are a number of lessons that organizers in other places can draw from our victory.  First, I think that – on any of these issues – we need to be as bold and aggressive as possible, and we need to pick some fights that deliver real tangible victories to people.   Going back to our victory on raising the minimum wage: over 100,000 people in Maine definitely got a raise from that victory.  Our estimates were that one in three workers in the state got a raise because of that victory.  That’s real to people.  And when one out of three workers gets a raise and they can identify your organizing work won them that raise, that strengthens your organization.  When 70,000 people get health insurance in a small state with 1.3 million people, then most people will know someone who either got health insurance through the victory or who got a job because of it. Half a billion dollars will come into Maine, and that will mean that people will have better jobs in rural hospitals, and they will be buying homes and buying cars.  So it’s important to pick fights that really do deliver.

The second lesson is that we can split Trump’s base if we take on fights that will improve the lives of people who are struggling economically. For the most part in the recent past, Maine has voted Democratic in national elections. But for the first time ever last year, we split our four electoral college votes, and we sent one vote to Trump. The state legislature has mostly been controlled by Democrats for 40 years, leading up to 2010 when the Republicans completely took over.  That’s when LePage – our right-wing Tea Party governor – won the governorship. Racism was a big part of LePage’s strategy, and it was pretty effective for him in 2010 and 2014. Then the legislature bounced back to Democrats in 2012, and it’s been split since 2014.  Democrats control the state House and the Republicans the Senate, but both by very narrow margins.  Over the last ten years, Maine has been pulled to the right, in general.  But even while that’s true, we also see a lot of hope, especially when we’ve done these referendums.  We’ve won same-day voter registration and a public financing- clean elections systems. We passed the minimum wage, and we passed a tax on the rich for education. We just won Medicaid expansion.  We’ve found that when you talk to people about what they care about and about what’s right and wrong, they can really get that.  And it moves people.   Take the people in the second Congressional District here in Maine. They have a lot to be angry and upset about. The old mill jobs are gone, and they are struggling economically. We need to try to fight to win solutions to their problems. It’s not surprising to me that they voted for Trump, but that they would also vote to raise the minimum wage and for Medicaid expansion. And fighting for these kinds of policies tips the hands of the Republicans who are claiming to speak to the experiences of people who are struggling.  Fighting on the programs like these forces the Republicans to come out and directly say that they oppose these programs that will help these people who are struggling, even when those people have directly voted in support of those policies.  We think that they might expose themselves so badly this year that we have hopes that it could actually mean that we would have a wave election in 2018.

You can read more about the organizing of Maine People’s Alliance here, and learn more about their upcoming campaign for universal home care here.

Did you enjoy this article?

We're in the middle of our annual fund drive, and this year we're building our own internal infrastructure for subscriptions, meaning more of every dollar pledged goes to fulfilling our mission. Subscribe today to support our work and be a part of Convergence's next evolution.