Advocates of a bill to expand Medicaid coverage for adults without children, cancer patients, working-class children and to clinics may be disappointed that their bill, LD 1303, was pared back in a compromise struck between its sponsor, House Speaker Michael Saxl, and Gov. Angus King. They shouldn’t be. With the discord and cash shortages that characterized this session, the proposal approved Thursday night established at least one important gain and sent needed funds to health centers, to the credit of both Speaker Saxl and Gov. King.

As envisioned by the speaker at the beginning of the session, LD 1303 would become the primary tool to offer insurance to everyone, either through generous definitions of poverty or an alternative buy-in that could have out-competed private insurers and saved money for beneficiaries. The bill would have been supported by a 26-cent tax on cigarettes. Instead, a 6-cent tax (with a yet-to-approved federal match) will make it possible to offer Medicaid to adults without children and with incomes up to 125 percent of poverty. Adults in that income range are unlikely to be offered insurance by employers and would not be able to afford it otherwise. Providing them with coverage is an important advance if for no other reason than it reduces one area of health-care financing where cost shifting masks the true cost of care for the insured.

The bill also sends $700,000 up front to rural health centers and a smaller amount annually to help them meet federal requirements for computer upgrades. The overall budget of the bill is to be controlled by the commissioner of Human Services, who can adjust eligibility based on expected costs, much like the current Cub Care program.

Without general Republican support and with the governor already leery about Maine’s Medicaid costs compared with those in other states, the Medicaid bill faced a fight from the beginning of the session. But Sen. John Martin got it right Thursday when he observed, “I see this as a major step forward. It’s the first time we are paying for single people without medical coverage,” he said. “It’s not everything that we asked for, but it is an acceptable compromise.”

Individual pieces from the bill, particularly the one to cover cancer drugs, no doubt will come up in future legislative sessions. They are well worth debating again and well worth funding.