Inside Augusta

Maine GOP Points Up Dangers, Unforeseen Consequences of MaineCare Expansion

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Fredette Medicaid

AUGUSTA – Members of the Joint Standing Committee on Health and Human Services gathered in Cross Office building Tuesday for a packed public hearing on a bill that would expand Maine’s Medicaid program – also known as MaineCare – to include individuals eligible under the federal Affordable Care Act – also known as Obamacare.

“This bill will allow Maine to expand medical coverage under the MaineCare program to adults who qualify under federal law,” said Rep. Linda F. Sanborn (D-Gorham), lead sponsor of L.D. 1066, An Act To Increase Access to Health Coverage and Qualify Maine for Federal Funding.

The bill’s cosponsors include seven Democrats, five Republicans and one un-enrolled lawmaker.

Sanborn introduced the bill on March 19 following Maine Health and Human Services Commissioner Mary C. Mayhew’s March 18 letter to Health and Human Services Secretary Kathleen Sebelius regarding Republican Gov. Paul R. LePage’s willingness to negotiate terms for Maine’s acceptance of Medicaid expansion under Obamacare.

[RELATED: LePage Offers Seblius Quid Pro Quo on MaineCare Expansion]

In her letter, Mayhew said the Governor is willing to expand MaineCare but only if the federal government funded Maine’s expansion at a rate commensurate with other states’, granted Maine increased flexibility via a “global waiver” program and agreed to fund expansion at 100 percent for ten years.

Democrats in Augusta took Mayhew’s letter as a sign that LePage might follow in the footsteps of several Republican governors, including Florida Gov. Rick Scott, who have caved to mounting public pressure and agreed to expand their state’s Medicaid programs.

Senate President Justin L. Alfond (D-Cumberland), House Speaker Mark W. Eves (D-North Berwick), Majority Leader Seth A. Berry (D-Bowdoinham), HHS Committee Co-Chair Sen. Geoff M. Gratwick (D-Penobscot), and Reps. Jane P. Pringle (D-Windham), Ann E. Dorney (D-Norridgewock), and Andrew M. Gattine (D-Westbrook). Sen. Richard G. Woodbury (U-Cumberland) is also a co-sponsor.

Republicans co-sponsoring the proposal include Reps. Carol A. McElwee (R-Caribou) and Ellen A. Winchenbach (R-Waldoboro) and Sens. Brian Langley (R-Hancock), Thomas B. Saviello (R-Franklin), and Rodney L. Whittemore (R-Somerset).

Maine’s Medicaid enrollment rate, at 27 percent, is the third highest in the nation and half again more than the New England average.

Speaker Eves said the bill would provide coverage for up to 70,000 uninsured Mainers.

“We all know people who could benefit from this,” said Eves. “I encourage you to think about those people.”

Sanborn said her bill was an “unprecedented opportunity” to expand health insurance coverage to Maine’s uninsured population and reduce health care costs by relieving the stress the uninsured place on emergency rooms. She said her bill would save Maine an estimated $690 million as the result of federal funds expansion would make available.

Her estimate comes from a November 2012 Kaiser Foundation study that shows Maine will benefit to the tune of $690 million because the state will be compensated for expansion that occurred in previous years. Several media reports, public statements, and even Eve’s testimony today, stated that both Kaiser and the Washington, D.C.-based Heritage Foundation have evaluated the impact of expanding MaineCare; however, Heritage’s report is merely a graph made with data from the original Kaiser study.

Placed in the context of Maine’s present biennial budget negotiations, $690 million is far from a panacea for the state’s budget problems. As Mayhew wrote, Maine is already facing cost-containment problems without MaineCare expansion: “Maine’s Medicaid enrollment has increased nearly 80% since 2002. We currently face a $270 million hole in our two-year budget as a result of increased cost in the program and the latest reduction to the federal reimbursement rate of our existing Medicaid program. Our hospitals are owed $484 million in unpaid Medicaid bills.”

House Minority Leader Kenneth Fredette (R-Newport) urged fellow lawmakers to put the potential federal proceeds in perspective and said a decrease in federal matching funds was “inevitable.”

Fredette pointed to a pattern in Maine’s relation with the federal government whereby promised federal funds are increasingly withdrawn and Maine is left with the tab.

“If history has taught us anything it’s that federal promises cannot be trusted,” said Fredette. “One legislature cannot bind another.”

Fredette told lawmakers that MaineCare reform will only happen on a bipartisan basis and said there are provisions which could be added to the bill that would entice Republicans, including an exception that would allow Maine to opt out of expansion if the federal government did not sustain the promised funding levels.

Assistant House Minority Leader Alexander Willette (R-Mapelton) said the option to opt out of MaineCare expansion a few years down the road might not go as planned.

“Since when have we ever been able to draw back entitlement spending?” he said, adding that Maine Republicans would face an uphill battle in any attempt to opt out of expansion should federal funding levels change in the future.

“I think the power is in your hands to do this in a bipartisan way,” said Fredette. “But you also have to remember that the Chief Executive has a role to play.”

“Instead of taking whatever money the federal government offers, stand with the Governor and get the best deal for Maine,” said Fredette.

“This is not is not an ideological issue. This is a business deal,” he said. “We can’t afford to put ourselves into an untenable position ten years down the road.”

By S.E. Robinson
Maine Wire Reporter

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About Steve Robinson

Steve Robinson was the editor of The Maine Wire from 2013 through 2014. A native of Dexter, Maine, Robinson is a graduate of Bowdoin College, and is currently a Producer for The Howie Carr Show in Boston.

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