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Court says Maine should start rolling out Medicaid expansion

August 23, 2018

PORTLAND, Maine (AP) — Maine’s top court Thursday left questions about the constitutionality of voter-approved Medicaid question unsettled as it told the LePage administration to start rolling out voter-approved Medicaid expansion as a legal battle continues.

The Maine Supreme Judicial Court dismissed the LePage administration’s appeal of court orders requiring the state to file paperwork to seek federal funding for expansion by June 11. The justices lifted a stay on those orders and said they are in effect, meaning the state must file the Medicaid expansion plan with the federal government.

The court also sent larger questions about the constitutionality of Medicaid expansion to the state superior court, and said questions about deadlines in the voter-approved law haven’t been settled yet.

“There are substantial unresolved issues surrounding the petitioners’ appeal ... and it is clear from the limited record before us that those issues must be resolved before we can consider the matter on the merits,” Justice Joseph Jabar wrote.

A lone dissenter, Justice Donald Alexander, said Maine shouldn’t be required to file the Medicaid expansion plan while there are still questions about how the state will pay for its share.

“The public and the taxpayers will also be harmed if shortfalls in Medicaid funding require tax increases or cuts in other programs or services to make up for the shortfall in Medicaid funding,” he wrote.

The court’s opinion was viewed as a “positive result” by advocacy group Maine Equal Justice Partners, which sued Republican Gov. Paul LePage’s administration to roll out Medicaid expansion.

“The state plan is going to get submitted and now the court is making clear that must happen,” said the group’s executive director, Robyn Merrill.

Nearly three out of five Mainers last November voted to allow adults under age 65 with incomes at or below 138 percent of the federal poverty line to apply for Medicaid coverage starting July 2. The LePage administration hasn’t said whether they will be denying or providing Medicaid coverage to such applicants.

The Associated Press, through Merrill’s group and a Maine community health center, has obtained copies of Department of Health and Human Services letters denying coverage for two Medicaid expansion applicants.

Advocates sued after Maine failed to meet an April deadline to file the paperwork required to request an eventual $525 million in annual federal funding for Medicaid expansion.

Republican Gov. Paul LePage has said he’d rather go to jail than jeopardize Maine’s finances by expanding Medicaid. LePage administration lawyer Patrick Strawbridge said he’ll be seeking guidance from the trial court on exactly what the next steps are.

LePage spokesman Peter Steele said the decision doesn’t address constitutional issues brought up by the governor, including whether lawmakers must pass a law paying for Maine’s share of Medicaid expansion.

The voter-approved law doesn’t include a way for Maine to eventually raise about $55 million in annual state funding for expansion. The first year of expansion could cost Maine $30 million after savings, but the LePage administration disputes estimates that Maine will see immediate savings.

Maine’s nonpartisan fiscal office estimates Maine has enough Medicaid funds to pay for expansion through next May.

LePage vetoed a bill to use surplus money and one-time tobacco settlement funds to fund Maine’s share of the expansion’s first year, instead insisting there be a long-term funding plan with no “gimmicks.”

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