Four Democratic candidates for governor Friday debated how to reform Maine’s health care system, with all supporting moving toward a universal health care system.

Dr. Nirav Shah, Hannah Pingree, Shenna Bellows and Troy Jackson — who are vying for the Democratic nomination in the June 9 primary election — agreed health care’s financial system is broken and needs a major overhaul. Angus King III was not present at the debate.

The forum at the University of Maine at Augusta was hosted by the Maine Center for Economic Policy think tank and Maine AllCare, which advocates for universal health care.

Shah, a former Maine Center for Disease Control and Prevention director, said in response to a question about a patient in rural Maine having difficulties scheduling an affordable colonoscopy, that the system is “absurd.”

He said the patient was being asked to be an insurance expert and schedule his colonoscopy “as if this young man was buying a TV.”

The system serves patients and rural health care providers poorly, Shah said.

“We treat rural hospitals like they are a restaurant, but we should treat rural hospitals like the fire department,” Shah said. “We should treat them like a public utility.”

Rural hospitals have closed in Maine or cut services, often by shuttering birthing centers. Northern Light Health’s Inland Hospital in Waterville closed in 2025.

Hannah Pingree, the former director of the Governor’s Office of Policy Innovation and the Future with the Mills administration, said cutbacks by the Trump administration to Medicaid and the Affordable Care Act mean Maine residents are losing access to health care.

Pingree said her plan would launch a public option to reduce the uninsured rate.

“My plan calls for a public insurance option so that individuals and small businesses can gain access to a plan if they can’t afford their insurance,” Pingree said.

The expiration of some ACA tax credits at the end of 2025 led to about 3,500 Maine residents canceling their insurance in 2026 because of the exorbitant costs, according to state statistics. Some people were seeing their insurance premiums climb to thousands of dollars per month.

Shenna Bellows, Maine’s secretary of state, said that if Maine could establish universal health care, residents could “imagine a world in which there wasn’t a deductible.”

“The health care system is broken and this is why we need bold, innovative state leadership,” Bellows said. “No one should be sick because they are poor, or poor because they are sick.”

Bellows said Maine should invest in health care by increasing the recently-passed millionaire’s tax, and by raising property taxes for out-of-staters who own property in Maine.

Jackson, the former Maine Senate president, said it’s not only Republicans who are against health care reforms. He said Gov. Janet Mills has vetoed prescription drug bills and has “not been willing” to “stand up and fight for health care.”

Jackson said the Canadian health care system, a single-payer, universal health care system funded by the government, is a model that should be emulated.

“I’ve never had a Canadian tell me that they didn’t like their health care system,” Jackson said. Some northern Maine residents “can literally look across the St. John River and see people with universal health care.”