Maine House Sustains LePage's Medicaid Expansion Veto

AUGUSTA – The Maine House of Representatives voted on Wednesday to sustain Gov. Paul R. LePage’s veto of the controversial expansion of Medicaid proposed under President Barack Obama’s sweeping healthcare overhaul.

Medicaid expansion was originally mandated under the Affordable Care Act (ACA), more commonly known as Obamacare. However, the 2012 decision of the U.S. Supreme Court found the mandate unconstitutional, giving states the freedom to choose whether to expand the welfare program, which is known in Maine as MaineCare.

Following House lawmakers 97-52 vote to sustain the governor’s veto, House Democrats immediately proposed a reconsideration and, after some parliamentary squabbling between House Speaker Mark Eves (D-North Berwick) and House Minority Leader Ken Fredette (R-Newport), tabled the motion.

While the vote to override the veto required a two-thirds majority, the subsequent votes to reconsider (93-56) and table (94-55) required only a simple majority. So despite two roll call votes sustaining the veto, Democrats’ procedural moves have kept the proposal on life support.

On the day of the vote, Department of Health and Human Services (DHHS) Commissioner Mary Mayhew urged citizens and lawmakers alike to consider the long-term implications of expanding Medicaid.

“We should not consider building on the current Medicaid program. Its financial foundation is crumbling and unstable,’’ said Mayhew. “We must fix the existing program and work with the federal government to create more flexibility, care for priority populations and to strengthen the financial foundation of this costly and unsustainable program.”

LePage said that over the last decade, Maine’s Medicaid program has grown rapidly and has moved away from its original intent to provide services for Maine’s most vulnerable.

“Maine’s Medicaid enrollment has gone from nearly 200,000 people in 2002 to 336,000 today and the total spending in Maine’s welfare program has increased by one billion dollars since 2002,’’ he said.

LePage denied a critical part of Democrats’ argument in favor of expansion, noting that Maine’s uninsured numbered 136,000 in 2001 and stood at 133,000 in 2011, despite a significant expansion of Medicaid in the interim.

The governor also stressed rising provider costs and shrinking reimbursement rates as a reason to oppose Medicaid expansion. Medicaid rates for healthcare providers have been repeatedly cut to address the ongoing financial shortfalls in Medicaid because of increasing enrollment and utilization, he said. The effect of decreased reimbursement rates, he said, has been a reduction in access to primary care services, as more and more physicians close their practices to Medicaid patients.

LePage’s veto of the Medicaid expansion bill (L.D. 1066) follows a sustained attempt to negotiate with the federal government for an expansion arrangement that was viable in the long-term for Maine and did not penalize Maine for prior Medicaid expansion. Central to these negotiations were the more than 3,100 elderly and disabled individuals on waiting lists waiting for critical services.

“Adding non-disabled individuals to our welfare program when we are failing to provide core services to thousands of disabled and elderly Mainers is unacceptable,” said LePage.

“I believe that our children, elderly and disabled should receive adequate services, but the reality is, the current system is not providing quality care to our most vulnerable,” he said.

Mayhew said that sustaining the governor’s veto will allow Maine more time to investigate whether the state can afford the long-term cost of expanding Medicaid.

“We must continue our conversations with the Federal government to expand flexibility and care for priority populations. The Legislature seems to have manufactured a false and unnecessary sense of urgency to make a decision on expansion immediately, rather than taking the time to make a sound and sensible policy decision.”

House Republicans were critical of the Majority Democrats procedural maneuvering on the third attempt to expand Medicaid. According to the House Republican Office, the Democrats did not inform Republicans that the veto override would come up for a vote.

Rep. Corey Wilson (R-Augusta), despite voting in favor of L.D. 1066, objected to Speaker Eves’ attempt to force the bill through, allowing his colleagues time enough to enter the chamber and cast dissenting votes.

Rep. Fredette said his colleagues’ parliamentary gymnastics showed just how desperate Democrats are to expand yet another welfare program.

“They have failed to convince enough lawmakers that it is a good idea, so now they are trying to muscle it through the legislature,” said Fredette. “We were appalled by the Democrats’ actions and are united in our belief that those tactics don’t belong here in Maine.”

Keeping Medicaid expansion on the table will allow Democrats, and sympathetic hordes of liberal activists, to lobby Republican lawmakers to flip-flop. Immediately following the vote, liberal advocates, who apparently had advanced notice of Democrats’ intentions, gathered at the State House to cry out for more welfare.

Assistant House Minority Leader Alexander Willette (R-Mapelton) said Republicans voted for the people who cannot come to the State House.

“Our vote today was for the people who can’t come to the State House to make their voices heard,” he said. “Our vote was for the thousands of elderly and disabled who sit on waitlists because the state’s welfare system has been stretched so thin that they can’t get the services they need. Medicaid was designed with them, not able-bodied young men, in mind. Our vote was for the hundreds of thousands of Maine taxpayers who will be asked to pay this tremendous welfare tab.”

Medicaid expansion would cost taxpayers $69 million in 2016 and 2017, $102 million in 2018 and 2019, and more than $150 million every biennial budget thereafter, according to DHHS estimates.

S.E. Robinson
Maine Wire Reporter
serobinson@themainewire.com