AUGUSTA, Maine - Supporters of Medicaid expansion in Maine are asking the courts to force Gov, Paul LePage to implement the program approved by voters last year.

LePage vetoed legislative attempts to enact the expansion, which advocates say would help an estimate 70,000 Mainers access health care. So, last year voters took the measure on directly, approving the expansion by a wide margin. But the governor has yet to file a state plan with the U.S. Center for Medicare and Medicaid Services, which was due on April 3.

According to Robyn Merrill, executive director of Maine Equal Justice Partners, another deadline is looming.

"The law is clear that people are eligible for coverage under Medicaid expansion as of July 2," she said. "So, on July 2, people will have a right to health care - and they will have legal recourse if they're denied coverage."

LePage has insisted that the Legislature needs to fund the expansion, about $45 million in the first year, without raising taxes or using the state's revenue reserve. However, Merrill said Medicaid expansion would bring significant amounts of money into the state.

"There's a fair amount of federal funding that will come into Maine, over $500 million a year," she said, "and in order to draw down those federal funds, filing the state plan, then, is part of that process."

Under the plan, state residents earning up to 138 percent of the federal poverty level, about $25,000 a year for a family of four, would be eligible for Medicaid.

If the lawsuit filed Monday in State Superior Court is successful, the court could order LePage to implement the expansion. Merrill noted that without coverage, each of the five petitioners in the suit faces delays in getting critical medical care.

"It's not exaggerating to say that it's life or death for some people," she said. "People just can't afford to wait any longer for the health care they need."

More information is online at mejp.org.


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A bill just introduced in Congress would raise public awareness of issues surrounding the end of life, including palliative care, and hospice.

The Compassionate Care Act would establish guidelines for advance care planning between health providers and patients.

Lisa Pahl, a licensed clinical social worker from Torrance, guides families through hospice.

"We live in a culture that is very avoidant of conversations on death and dying," Pahl observed. "Public education around the importance of planning ahead will improve access, so that everyday Americans know to ask for hospice and palliative care."

The bill would direct the government to develop education resources for providers, expand telehealth options and facilitate a study of a national advance care planning registry, which would allow patients to transfer their advance directives from state to state.

Pahl encouraged people to spell out what they want at the end of life so their relatives do not have to make expensive and painful decisions.

"Unless we have these conversations, we won't know," Pahl pointed out. "Health care providers typically will err on the side of doing it all, rather than going with comfort measures."

The bill is co-sponsored by Rep. Nanette Barragán, D-Calif., and Sen. Richard Blumenthal, D-Conn. A similar bill stalled in the House of Representatives in 2020 and never got a vote.


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The National Association of Community Health Centers is meeting in Atlanta this weekend to address the issues affecting the health care system as more people seek essential services.

In Georgia alone, about 400 centers serve more than 700,000 patients each year. With underfunded primary care, workforce shortages and rising drug costs, doctors said the need for the centers is increasing.

Kyu Rhee, president and CEO of the association, said community health centers have seen an increase of almost 3 million patients in the last four years.

"Community health centers have served as the employer, provider and partner of choice across our nation since 1965 nearly six decades," Rhee pointed out. "And now serve one in 10 people across our nation, or over 32-and-a-half million people"

Despite the growth, Rhee believes the demand for community health centers is even greater and they should be reaching one in three people based on national health needs. Gov. Brian Kemp and Dr. Mandy Cohen, director of the Centers for Disease Control and Prevention, are slated to speak at the conference.

Rhee noted 90% of those served at the centers live below of the federal poverty level, meaning access to care can often be hindered by various barriers. He emphasized a key strength of these centers is the ability to meet patients where they are, extending care beyond the exam room and financial status.

"If you think about other parts of the health system, in general, you have to have a certain type of insurance you have to pay before you're seen," Rhee observed. "The beauty of what community health centers deliver is that we serve everyone, regardless of their ability to pay."

As the conference delves into health care issues, Rhee stressed the importance of examining the roles of other providers and the pharmaceutical industry, both crucial in supporting the mission of community health centers and the populations they serve.


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Wildfires are becoming bigger and more frequent in Colorado and across the Mountain West, and health experts are offering tips to breathe easy even during bad air-quality days.

Dr. Anuj Mehta, pulmonary and critical-care physician at Denver Health said pregnant women, infants, children, older adults and people with heart or lung disease are most at risk.

"Wildfire smoke has a lot of particulate matter. So really, really small microscopic particles that can cause inflammation in the lungs. Just breathing in that particulate matter, that inflammation may not just stay in your lungs. It can really cause inflammation around your body," Mehta said.

Exposure to smoke from wildfires has been linked to an increased risk of heart attack, stroke, lung cancer and a decline in cognitive function. Using air purifiers with HEPA filters and high MERV rated air conditioning filters can improve indoor air quality. Limiting strenuous activities is also a good idea, because when your breathing rate goes up, you inhale more particulates.

Workers and others who need to be outdoors can get air-quality updates on particulate matter and ozone pollution levels online at colorado.gov/airquality. Mehta says N-95 masks and respirators can also help, if worn correctly.

"If you can be indoors, that's going to be really good. If you have to be outdoors, and you are somebody with underlying breathing problems, wearing the mask actually can reduce the amount of particulate matter that you are going to breathe in," Mehta continued.

Colorado has already seen six wildfires that have burned more than 1,000 acres since May, and as humans continue to burn fossil fuels, wildfire risks are widely expected to increase into the foreseeable future. Mehta said it's important to understand the risks, and to be prepared.

"So every summer we're going to be dealing with bad air quality days. And so people, especially people with underlying health concerns, should be discussing with their medical teams about a bad air-quality plan," Mehta continued.


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