Approximately 200 people filled the State House Wednesday for a rally supporting the expansion of Medicaid, the publicly funded health insurance program for the poor, elderly and disabled.

The event, organized by the liberal activist group the Maine People’s Alliance, featured several individuals who lost their Medicaid coverage on Dec. 31 because of changes passed by the previous Legislature, but would regain it if the Legislature approves expanding the program this session.

The debate over Medicaid expansion is raging in state capitols all over the country, fueled by policymakers considered key opponents of the federal health care law.

In Maine, it is expected to be one of the more contentious issues of the legislative session.

Expanding the program through the Affordable Care Act would benefit approximately 60,000 Mainers who make less than 138 percent of the federal poverty level. The federal government would fully fund expansion for three years, before gradually drawing down to a 90 percent reimbursement rate by 2020.

Opponents, including Gov. Paul LePage and many Republican lawmakers, say Medicaid expansion carries hidden costs and that the state budget already suffers from previous program expansions.

During the State House rally, several speakers said they could not afford private health insurance and did not qualify for subsidies available through the Affordable Care Act. The so-called coverage gap affects approximately 24,000 Mainers, or roughly 19 percent of the state’s uninsured population.

Several of them discussed their experiences on Wednesday.

Pete Miller, who lives in Ellsworth and is a prep cook at Pat’s Pizza, said he cannot afford to buy private health insurance. He said he has a blood clotting issue that forces him to have his blood drawn regularly and to take blood-thinning medication. He had been on Medicaid – known here as MaineCare – for several years before losing his coverage at the end of December.

Asked how much it would cost him to buy private insurance, Miller said, “More than I can make.”

Joseph Kubetz of Portland said he’s in relatively good health but has no health insurance. He recently started a new landscaping business and worries that one accident or health setback could sink his business.

Tom Benne, a self-employed farmer from Whitefield, said he also fell into the coverage gap and lost his Medi- caid coverage in 2013. He had a hip replacement in 2012.

“In 2010 my wife had a heart attack,” Benne said. “Because of MaineCare she got the care she needed and made a full recovery. We lost our MaineCare on (Dec. 31).”

He said they went to a navigator to try to purchase health insurance through the Affordable Care Act and discovered they couldn’t qualify for subsidies.

“I’m in the gap. We’re both in the gap,” he said.

After the rally, activists moved upstairs to lobby lawmakers between the House and Senate chambers.

Mike Tipping, a spokesman for the Maine People’s Alliance, said the rally was one of the group’s largest turnouts for a so-called “lobby day.”

Nonetheless, advocates for expansion have a tough road ahead.

Beth O’Connor, chairwoman of Maine Taxpayers United, who joined members of that group at the State House Wednesday, said Maine had already seen the effects of Medicaid expansion. O’Connor, a former state representative, said expansion would mostly benefit able-bodied Mainers.

“They’re going to the front of the line,” she said. “And once again the 3,100 people (who are on a waiting list) are getting kicked back.”

O’Connor added, “Frankly it’s a disincentive. People won’t get off their butts and try to get a job. What we need to do is focus on the economy so that more people can find work.”

Three of the four Republican legislative leaders have said their resolve to fight expansion has stiffened since last session.

In 2013, an amendment expansion bill fell several votes short of overriding LePage’s veto. The amendment, authored by Assistant Senate Minority Leader Roger Katz, R-Augusta, was designed to ease some Republicans’ concerns over expansion by including a review of the program and a sunset provision that would roll back coverage if an independent study commission found that health outcomes didn’t improve or the cost of managing the program was too high.

Rep. Kenneth Fredette, R-Newport, the House minority leader, said during a news conference Wednesday that his caucus had little reason to vote for expansion.

Fredette cited recent findings from a Harvard University study evaluating impacts of Medicaid during a long-term experiment in Oregon.

The study rebutted a key argument by expansion proponents that access to health care reduces emergency room visits. The Oregon study showed a net increase.

Jonathan Gruber, a health economist at the Massachusetts Institute of Technology, told the Washington Post that the findings showed there was “a misleading motivator for the Affordable Care Act.”

“The law isn’t designed to save money,” he said. “It’s designed to improve health, and that’s going to cost money.”

Another Harvard study last year found that Maine could prevent around 395 deaths per year by expanding Medicaid.

Fredette and Republicans remain unconvinced.

“It seems every day we’re hearing new reasons to reject this massive expansion of welfare and instead pursue reforms like the successful one passed by Maine Republicans in 2011,” he said.

Legislative Democrats, who have made Medicaid expansion a priority for the session, say they’re undeterred.

“What we heard today is what we hear from our neighbors at home: People want and need life-saving health care,” said House Speaker Mark Eves, D-North Berwick, in a prepared statement. “They don’t understand why politics and ideology are holding up common sense care.”

Senate President Justin Alfond of Portland said there were moral and economic arguments for expansion. “Making sure folks have access to health care without the fear of going bankrupt is something we all value and it’s something we will continue fighting for,” he said in a statement.

Democrats have cited several studies to bolster their pro-expansion arguments, including a study by the Kaiser Family Foundation that found that Maine is one of 10 states that would save money by expanding Medicaid.

Kaiser found that Maine would save $690 million over the next decade from Medicaid expansion.

Another study by the pro-health care reform group the Commonwealth Fund, said Maine could lose $294 million by 2020 by not expanding Medicaid.

That’s because the federal government pays for Medicaid expansion with taxes on residents in all states, regardless of whether a state expands or not.

A public hearing for the bill that would expand Medicaid will take place Jan. 15.

Steve Mistler can be contacted at 791-6345 or at:[email protected]Twitter: @stevemistler