Opponents of Medicaid expansion make a mistake in pointing to Maine to argue that extending Medicaid to more people did not increase the number of people with insurance. In fact, Maine has been more successful in keeping its residents insured than most of the rest of the states in large part because it extended Medicaid to more low-income adults.
Maine first expanded its program to cover low-income childless adults in 2002. During that time, the uninsurance rate among childless adults in Maine fell from 40 percent to 27 percent. In 2005, Maine put an enrollment cap on the program, effectively prohibiting more adults from enrolling. Maine’s uninsurance rate would have declined even more were it not that some applicants were excluded by the cap. Nationally during this time, the share of the U.S. population under the age of 65 without health insurance grew from 15.2 percent to 17.9 percent.
But even with those circumstances, Maine managed to keep more people covered than most other states and during a recession. While the unemployment rate in New Hampshire went from 3.5 percent to 5.4 percent, in Maine it rose from 4 percent to 8 percent.
However, Maine saw no comparable increase in the percentage of adults without health insurance during this time. Instead it saw a slight decrease from 12.2 percent to 11.8 percent between 2001 and 2011 even as thousands of people lost their jobs – and their employer-sponsored insurance – in the recession. In other words, despite an enrollment cap and dire economic conditions, Maine was more successful in keeping its residents insured largely because of its Medicaid expansion.