LePage: Lawmakers must act for Maine to get Medicaid dollars

April 1, 2018

AUGUSTA, Maine (AP) — Maine’s Republican governor has claimed without providing evidence that President Donald Trump’s administration will only let the state expand Medicaid if lawmakers put the money up.

Meanwhile, the tens of thousands of low-income individuals who could benefit from voter-approved Medicaid expansion are still waiting for Gov. Paul LePage’s administration and lawmakers to take action.

The issue will likely end up in court, which could leave a new Legislature and governor hashing out funding next year. Advocacy groups say legal action is possible if the governor blocks expansion.

“This is an issue that is life and death in some cases,” said Robyn Merrill, executive director of Maine Equal Justice Partners, a legal aid organization that’s long led efforts to expand Medicaid despite LePage’s opposition. “People have gone too long without health care they need.”

Lawmakers have yet to comply with LePage’s demand to cover administrative costs and Maine’s share of expansion without raising taxes, dipping into rainy day funds or relying on budgetary tricks. Democratic Rep. Drew Gattine said he hopes to hold a public hearing soon on funding.

“What’s really pressing is that the department needs to do the up-front work it’s required to do under the law,” Gattine said. The LePage administration has provided “cut-and-paste” monthly expansion updates with few details, he said.

For months, the LePage administration has refused to take steps to ensure Maine receives an estimated $500 million in annual federal funding for expansion, which is slated for July 2.

The administration faces a Tuesday deadline to send a routine federal application, but Department of Health and Human Services spokeswoman Emily Spencer confirmed Friday the department has no plans to do so without funding from lawmakers.

“Recently, we talked to the current administration. In order for them to approve a state plan amendment, they have to know the money is available,” LePage recently told The Associated Press. His office and the U.S. Centers for Medicare & Medicaid Services didn’t respond to requests for evidence backing the claim.

“Denying or failing to act on a (state plan amendment) on this basis is unprecedented and would clearly be done in an effort to thwart a policy they don’t like but is available under law,” Merrill said.

The LePage administration is declining to estimate savings from Medicaid expansion. The Office of Fiscal and Program Review projects $54 million in annual state costs after $27 million in savings, while the Maine Health Access Foundation estimates $62 million after savings.

Maine has enough money to fund its share of expansion before running out in mid-2019, said Office of Fiscal and Program Review analyst Luke Lazure. But Spencer said the agency only spends money as outlined in the budget, adding: “Any additional spending would require a reduction in current expenditures within other areas of the program.”

LePage, who paid nearly $500 million in Medicaid debt to hospitals, said: “There’s a difference between running out of money and having the money.”

Lawmakers passed Medicaid expansion five times but faced successive vetoes by LePage. The governor’s also asking the Trump administration to require certain Medicaid recipients to work, volunteer and face monthly premiums.

Legislators are also jockeying over an estimated $130 million in additional revenue through summer 2019.

“Frankly, we’ve done very little,” said Republican Rep. Tom Winsor. He said his caucus’ priorities include another year of rate increases for providers serving individuals with intellectual disabilities.

Republican House Leader and gubernatorial candidate Ken Fredette said legislative leaders aren’t in agreement on spending priorities, and said any deal must include tax relief. Democratic House Speaker Sara Gideon said Democrats want public discussions on funding.

When asked whether lawmakers could dip into the surplus, LePage said: “It’s up to them.”

“They want to wait until the next governor,” LePage later said. “They don’t know how to fund it, that’s the problem.”

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