PORTLAND — As part of a wide-ranging 10-point health care plan he unveiled Monday, Democratic candidate for governor Mike Michaud reiterated his support for expanding Medicaid to 70,000 uninsured Mainers and making investments in preventative health care programs.

The plan earned positive responses from health care advocates, though they said there is little in it that has not been discussed before.

“It’s not Earth-shattering,” said Gordon Smith, executive vice president of the Maine Medical Association, which does not endorse political candidates. “It’s all good stuff. It’s not particularly innovative, but it’s thoughtful, and there are a lot of positive things in it.”

Michaud has long said one of his first goals as governor would be to accept federal dollars offered under the Affordable Care Act, something that Gov. Paul LePage has refused to do — vetoing five such proposals sent to him by Democratic legislators in the past two years. LePage, Republican lawmakers and their supporters have argued that past expansions of Medicaid eligibility caused major debts to Maine’s hospitals and funneled money away from other health care programs.

“Michaud’s health care plan is centered around the expansion of welfare, just like the one he pushed while in the Maine Senate that caused our massive, welfare hospital debt,” said LePage campaign spokesman Alex Willette, repeating a claim the LePage campaign has been making for months.

Michaud fired back by calling LePage “fiscally irresponsible” for both the way he paid back the hospital debt — by borrowing — and for opposing Medicaid expansion, which Michaud said puts more financial pressure on hospitals to deal with uncompensated care.

“Yes, the hospitals got paid back, but (LePage) borrowed money from Wall Street to pay the hospitals back, and he’s paying interest,” said Michaud. “I would have paid that back with money. I would not have borrowed the money.”

LePage, backed by bipartisan support in the Legislature, paid past Medicaid debt to the state’s hospitals by renegotiating the state liquor contract and using the increased state profits to repay a 10-year revenue bond. The $220 million bond was taken with an interest rate of about 3.8 percent.

LePage has talked about health care very little on the campaign trail, and his campaign website makes virtually no mention of it, other than his opposition to Medicaid expansion. Willette said the governor and Republicans took a major step in 2011 with the passage of PL 90, which among other things created a high-risk insurance pool funded by a monthly fee on insurance premiums and eliminated the requirement that insurance rate hikes of less than 10 percent be reviewed by the Bureau of Insurance. Asked how LePage would cover the state’s uninsured poor, Willette said many of them are eligible to buy government-subsidized policies through the Affordable Care Act.

“The reality is that the governor has already pushed through reforms with PL 90,” said Willette. “Unfortunately, the Affordable Care Act has really taken over health care and insurance and made it a national issue to the point that the state can do less and less to impact the price of health insurance.”

Michaud also said Monday that his health care plan goes deeper and looks further into the future than those of LePage or independent Eliot Cutler, his rivals in the Blaine House race. One way it does that is with a focus on preventing sickness in the first place.

“My plan takes a broader view and puts individuals at the center of our efforts,” Michaud said. “The most efficient way to contain health care costs is to reduce chronic diseases.”

Cutler, who is polling a distant third behind his major-party rivals, said Monday afternoon that there is little that separates himself and Michaud when it comes to health care policy.

“There’s not enough differences between the two of us to really say that it’s dramatic,” said Cutler on Monday afternoon in an interview with the BDN. Cutler released his health care plan last year and said the major difference between it and Michaud’s is the person standing behind it.

“I think this is a huge challenge for Maine’s next governor, and I don’t think Mike is up to it,” said Cutler, repeating an often-used campaign theme.

Michaud said his strength, when it comes to health care or solving any other problem, is that he’s a consensus builder. It’s a narrative he and his supporters have pushed with greater frequency in recent weeks as they have increased their focus on LePage’s leadership style.

“For nearly four years, Gov. LePage has sought to divide people and turn them against one another,” said Michaud, who proposes partnering with other governors in the Northeast to tackle the state’s opiate addiction problem. “I know that by working together, we can help Mainers live healthier lives.”

Michaud’s plan also calls for partnering with Maine businesses for the development of a results-based health insurance system, reforming the way hospitals and doctors are paid for their services so they are rewarded for good health outcomes for their patients, and training insurance enrollees about programs available to them through their policies.

Nancy Morris, a spokeswoman for the Maine Health Management Coalition, said most of the members of her organization — which also doesn’t endorse political candidates — are particularly interested in Michaud’s proposal to change how doctors and hospitals are paid through a move away from a service-by-service-based billing system to one that focuses on certain medical outcomes. However, she said just because many people recognize the solutions doesn’t make them easy to enact.

“We could see significant savings,” she said. “Any candidate who’s running just has to recognize that if this was simple to fix, it would have been fixed long ago.”

Michaud said Maine’s economic future depends on creating a stronger health care system.

“We need to think about people not as a collection of ailments, to be treated as cheaply as possible, but as members of our community who want to be healthy, live independently and be treated with respect at all stages of their lives,” Michaud said. “Health care is not a privilege for those who can afford it. It’s a right that all Mainers deserve.”

Getting it Right for Health