Maine and Medicaid: Did Troy Jackson expand coverage and Susan Collins vote for cuts?

A TV ad says Democratic U.S. Senate candidate Troy Jackson and Sen. Susan Collins, R-Maine, have opposing stances on healthcare for low-income people.

“Troy Jackson expanded Medicaid health coverage in Maine,” the Sept. 4 ad said. “Susan Collins was the deciding vote for Trump’s Medicaid cuts kicking tens of thousands of Mainers off health coverage so they could give billionaires a tax break.”

WinSenate, a super political action committee linked to Senate Majority PAC, created the ad. A super PAC is a political action committee that can spend unlimited amounts of money to campaign for federal candidates.

Did Jackson expand Medicaid and Collins vote to cut it?

While he was in the Maine state Senate, Jackson pushed for the expansion of MaineCare, the state’s Medicaid program. But the ad overstates Jackson’s role in its ultimate expansion. State legislation failed to make expansion a reality because then-Gov. Paul LePage, a Republican, vetoed it. Ultimately, it was voters and Democratic Gov. Janet Mills who made the expansion a reality. 

The ad also misleads about Collins’ voting record on President Donald Trump’s signature tax and spending legislation, the One Big Beautiful Bill Act.

Maine Democrats, including Jackson, sought Medicaid expansion

The Affordable Care Act, which passed in 2009, expanded who could be eligible for Medicaid starting in 2014. States could choose to participate in the expansion of the healthcare program for low-income people, and the majority did. 

When we asked the PAC and Jackson’s campaign about their evidence that Jackson expanded Medicaid, their spokespersons sent us information showing for years Jackson sponsored and voted for legislation supporting expansion.

During a 2013 Senate floor debate, Jackson said he had two friends who died after having similar health problems to his own. As a legislator, Jackson had health insurance, but his friends did not. Jackson called it an “embarrassment that I’m alive and they didn’t have that opportunity.”

In 2014, Jackson said “health care is a right, and lawmakers who get healthcare from the state should think twice before denying it to their constituents.”

LePage vetoed expansion bills five times. (LePage is running for Congress in November.)

Advocacy groups then tried a different strategy: They collected voters’ signatures to place a question on the ballot. Jackson advocated for its passage, and voters agreed in 2017 to expand Medicaid.

Jackson, then the senate minority leader, said that his party “will not give an inch in this fight,” which he called “a matter of life and death” for many Mainers.

In 2018, Jackson supported funding the expansion, but LePage again vetoed it. The governor refused to implement Medicaid expansion in defiance of court rulings.

In January 2019, Mills was newly elected when she signed an order to implement voters’ wishes.

“Today marks a huge win for the health and well-being of our state,” Jackson, then the senate president, said at the time, adding that it would provide addiction treatment and help rural hospitals. 

A Mills spokesperson said her order expanded Medicaid to over 230,000 people since 2019. The numbers can fluctuate month to month; as of June 2026, there were just over 85,000 people enrolled through Medicaid expansion.

Collins also has supported Medicaid

We’ve rated False previous claims that Collins sided with Trump on Medicaid cuts.

The text on the WinSenate ad says “Collins was the deciding vote for Trump’s Medicaid cuts” and attributes the “deciding vote” phrase to WABI-TV. The station’s July 2025 report said Collins was the deciding vote to “advance the bill” but then said she voted against the final legislation. 

In June 2025, Collins voted on a motion to proceed on the One Big Beautiful Bill Act. She warned unless there were substantial changes, she would vote against its passage.

Collins voted in support of several amendments, including Democratic ones, to protect Medicaid. When those efforts failed, she voted against the bill’s passage.

Collins said she supported tax relief but primarily voted against the bill because of “the harmful impact it will have on Medicaid, affecting low-income families and rural health care providers like our hospitals and nursing homes.” 

Had Collins voted “no” on the procedural vote, Vice President JD Vance was on hand to break the tie.

The legislation provided tax benefits for people of varying incomes, but wealthier taxpayers came out ahead. It also made historic cuts to safety net programs including Medicaid.

Our ruling

A WinSenate ad said, “Troy Jackson expanded Medicaid health coverage in Maine. Susan Collins was the deciding vote for Trump’s Medicaid cuts.”

As a state senator, Jackson advocated for Medicaid’s expansion, but the ad overstates his role. He consistently sponsored and voted for related legislation. LePage vetoed those efforts just as consistently. Jackson also supported a referendum that voters approved in 2017; LePage blocked it. Ultimately, Mills delivered on Medicaid expansion by acting on that voter approval. 

The ad distorts Collins’ record on Medicaid. She cast a vote to move legislation forward but warned that if the legislation didn’t change, she would reject it. When the final bill came up for a vote, Collins voted against it, citing its Medicaid cuts as her reason.

We rate this statement Mostly False.

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