Published in the Portland Press Herald on May 13, 2026
by Tom Sterne, MD, lives in Bridgton, and David Jolly, DrPH, lives in Penobscot.
The Legislature passed a plan in 2021 that is contingent on federal action in order to take effect. It’s time to remove that condition.
It is not widely known, but in 2021, the 130th Maine Legislature enacted a universal healthcare plan for the state. Public Law 2021, Chapter 391, An Act to Support Universal Health Care, states: “The Maine Health Care Plan is established to provide for all medically necessary health care services for all residents of the State.”
The law calls for the appointment of the Maine Health Care Board, which would be responsible for designing a state-based universal healthcare plan and recommending it to the Legislature for enactment.
Thus, the Legislature affirmed that a) all Mainers deserve healthcare and b) it is the responsibility of the state government to ensure that they have it. By doing so, the Legislature acknowledged that healthcare is a right. The sponsors and supporters of the legislation should be commended for their wisdom and farsightedness.
But there is a catch. The law does not take effect until “federal law is enacted that authorizes a state to obtain a waiver to establish a state-based universal healthcare plan and to receive federal financing for that plan.” The requisite legislation, the State-Based Universal Health Care Act (SBUHCA), was first introduced by Rep. Rho Khanna in 2019. It has been reintroduced a number of times since, but in all these years no action has been taken, despite strong public support for universal healthcare.
We should not wait any longer, and we don’t have to. We at Maine AllCare propose that we move forward by amending the Maine Health Care Act to remove the contingency that federal legislation must first be passed for the law to go into effect.
If this were done, it would trigger the establishment of the Maine Health Care Board. The board would be appointed by the governor and consist of members representing patients, employers and healthcare providers of various specialties. The board would then be required to design a detailed plan, study its economic feasibility, obtain the necessary federal waivers and then implement the plan following approval by the Legislature.
In designing a plan, the board would not have to start from scratch. There are several detailed proposals that the Maine Legislature has considered over the past 15 years that could be used as a starting point or template. Most recently, there is a detailed plan created by us at Maine AllCare, a nonprofit organization that advocates publicly funded universal healthcare. Under the plan, healthcare would be publicly funded, but delivery of care would continue to be in private hands, with the exception of the already existing public providers like the Veterans Health Administration.
It is a truth universally acknowledged that our healthcare system is serving us badly. And too many of us are uninsured and are not being served at all. Every day there are reports that Maine is facing a healthcare crisis. Hospitals are in dire financial shape, which will become worse with upcoming cuts in Medicaid payments. Thousands of Mainers are losing their coverage under MaineCare. Surprise medical bills are plunging even those with insurance into debt and bankruptcy.
We were greatly heartened when, at a recent forum of Democratic gubernatorial candidates, we heard all candidates present speak favorably about our proposal. Anyone running for elective office this year would do well to follow their example, support the formation of the Maine Health Care Board and pledge to move Maine forward now on universal healthcare at the state level, as more than 20 other states are doing.
Our lawmakers in Augusta took a bold step when they passed the Maine Health Care Act. By taking one simple step further, they can help us realize that promise. We know the public wants it. Establishing universal healthcare in Maine would be a fine legacy for lawmakers to leave.