Updated at 6:50 a.m. ET
Voters in Maine have easily approved a referendum to expand Medicaid for low-income adults, doing an end-run around Republican Gov. Paul LePage, who vetoed the move — a key element of Obamacare.
Maine is one of a handful of states deciding major issues by referendum on Tuesday, including New York and Ohio.
Maine's Question 2 passed by about 60 percent. The measure is seen as a bellwether for continuing support of the Affordable Care Act, even as Republicans have tried repeatedly to unravel the Obama administration's signature health care bill.
The vote would bring Maine, which has been hit hard by the heroin epidemic, in line with 31 other states that have expanded their state programs. An estimated 80,000 Maine residents will qualify.
It is the first time such an expansion has been mandated by referendum, and as NPR's Brett Neely has written, it "could energize organizers of similar campaigns for 2018 across the country, including in Utah and Alaska."
Politico adds that voters hope "to bypass state legislators hostile to the Obamacare program that sank past efforts. That dynamic has also squashed Medicaid expansion efforts in Tennessee, Wyoming and South Dakota, where GOP governors tried and failed to get legislative backing for expansion plans. In Kansas, the GOP-controlled legislature passed legislation earlier this year only to see it vetoed by Gov. Sam Brownback."
The Portland Press Herald reports that turnout in Maine was higher than expected at the polls, with voters driven primarily by the Medicaid expansion measure, although the newspaper reports that "voters statewide were [also] considering referendums on a casino in York County, a $102 million transportation bond and a constitutional amendment dealing with changes to state employee pensions."
Meanwhile, voters in New York rejected a measure calling for a constitutional convention on the state's founding document. With most of the state's precincts reporting, the measure was easily defeated.
The New York Times reports: "The campaign against the constitutional convention drew a diverse collection of opponents, including conservative political groups, major labor groups like the A.F.L.-C.I.O., and liberal stalwarts like the New York branch of Planned Parenthood and the New York Civil Liberties Union. And while their concerns were often different, the basic logic of the anticonvention forces was similar: Such a convention could result in an erosion of protections for everything from collective bargaining rights to free public education."
In Ohio, a measure to limit the price on prescription drugs purchased by the state, which was strongly opposed by the pharmaceutical industry, was defeated. The referendum called for capping what the state pays for pharmaceuticals to the same price paid by the federal Department of Veterans Affairs for the same drugs.
The "no" vote was about 80 percent.
Cleveland.com writes: "The proponents hoped to bank on the unpopularity of the drug companies in Ohio as well as ill will toward them in general after recent price gouging controversies. The opposition backed by Big Pharma had nearly unlimited resources, outspending the Yes side by three-to-one over the course of the campaign."