Health advocates say they will try for a sixth time to expand Medicaid when the Maine Legislature convenes in January. But if expansion fails once again to overcome a veto by Gov. Paul LePage, they now have a Plan B – to put the measure before voters in a referendum in 2018.

Speaking at a Thursday news conference at the Greater Portland Health clinic in Portland, leaders of Maine Equal Justice Partners, an Augusta-based progressive advocacy group, announced a petition-gathering campaign that will begin soon and ramp up on Election Day.

Ann Woloson, policy analyst for Maine Equal Justice Partners, said dozens, perhaps hundreds of volunteers will stand outside polling locations on Election Day to gather many of the 61,123 signatures needed to place the issue before voters in 2018. Woloson said it’s possible but unlikely that there would be enough time to have a referendum on the ballot in 2017.

“Election Day is a big opportunity for us,” Woloson said.

Woloson said the goal is to have the signatures gathered and ready for a 2018 ballot proposal by this spring, so that lawmakers can see that if they don’t approve expansion by a veto-proof margin, voters could choose to bypass the governor’s veto. If the referendum was approved, LePage could not veto it.

She said non-public polling she’s seen shows that Medicaid expansion would be popular in Maine. A publicly-released December 2015 statewide poll commissioned by Sen. Tom Saviello’s Political Action Committee showed 58 percent of Mainers supported Medicaid expansion. Saviello, a Wilton Republican, is a strong supporter of Medicaid expansion whose compromise plan this spring did not survive a threatened LePage veto.

Saviello’s poll appears to be the only publicly-released poll that gauged support of Medicaid expansion.

In a June 2016 poll for the Press Herald/Maine Sunday Telegram, Mainers were evenly divided on the question of whether they supported the Affordable Care Act, with 40 percent supporting and 41 percent opposed. Medicaid expansion is part of the ACA, but a 2012 U.S. Supreme Court decision determined that states could choose whether or not to accept expansion. So far, 32 states have expanded Medicaid.

While most Republicans have sided with the governor on Medicaid expansion, some moderate Republicans, like Saviello and Sen. Roger Katz of Augusta, have supported expansion. Saviello said the makeup of the state Legislature will also be closely watched, especially if more Democrats or moderate Republicans are elected, making a veto-proof majority more likely.

Dr. Chuck Radis, a semi-retired Portland rheumatologist who is helping MEJP on the campaign, said the expansion would help more than 70,000 people and he’s seen first-hand how patients without insurance struggle with health care costs.

“They are one illness away from losing everything,” Radis said.

Adrienne Bennett, a LePage spokeswoman, said in an email response to questions that Medicaid expansion would “bankrupt” the state.

“Furthermore, any individual who earns at least 100 percent of the federal poverty level is eligible to purchase heavily subsidized health insurance on the federal exchange,” said Bennett, referring to the Affordable Care Act’s health insurance marketplace that offers subsidized insurance for individuals earning between 100 and 400 percent of the poverty level.

Woloson said expansion would actually generate millions per year in savings for the state, in part because the state would be drawing down federal dollars for programs that are currently funded entirely by the state, such as some substance abuse treatment programs.

“This is the largest economic stimulus opportunity that Maine has before it,” Woloson said.

The Legislature’s nonpartisan Office of Fiscal and Program Review estimated the state would spend $93 million in state tax dollars on expansion through 2019, but receive nearly $1.2 billion in federal funds. The federal government would pay for 95 percent of Medicaid expansion in 2017, followed by a reduction in the federal share to 90 percent by 2020. The federal government has promised to maintain the 90 percent reimbursement rate, but LePage has said he expects the federal government to renege on its promise and leave state taxpayers on the hook to make up the difference.

Kathy Phelps, 60, a Waterville hairdresser, said the state eliminated her Medicaid benefits in 2013 when the LePage administration tightened eligibility, and she hasn’t qualified since, causing her much hardship because she has chronic respiratory problems. Phelps, when asked by the Press Herald, said she didn’t know whether she would be eligible for Affordable Health Care insurance, which would be available to her at a heavily-subsidized rate if she could make more than $11,880 per year. Premiums would likely be $10-$20 per month or less. Phelps said she would check into whether she would qualify because she needs the insurance. Someone working 40 hours per week at minimum wage would earn about $15,000 per year and be eligible for ACA subsidies. But regardless of her personal situation, Phelps said the state should expand Medicaid.

“This is the right thing to do for our state,” Phelps said.