AUGUSTA – Governor Paul R. LePage today reiterated his recommendation that the State of Maine will not develop a state-based health insurance exchange as part of the implementation of the Patient Protection Affordable Care Act (PPACA also referred to as ACA).
Because the guidance issued in the August 13, 2012, request of the U.S. Department of Health and Human Services (HHS) is not legally binding, the State of Maine will not be submitting a Declaration Letter. Instead, Gov. LePage, in a letter to U.S. HHS Secretary Kathleen Sebelius, noted that the State of Maine has repeatedly stated that the law has severe legal problems, is bad policy, and overreaches into the lives and pocketbooks of fellow Americans.
“Maine will not build a state health insurance exchange as outlined by the ACA. We are not going to assist in implementation of this bill in its current form,” wrote Governor LePage. “The ACA is full of federal mandates; as such, even a state-based health insurance exchange is actually controlled by the federal government. In the end, a state exchange puts the burden onto the states and the expense onto our taxpayers, without giving the state the authority and flexibility we must have to best meet the needs of the people of Maine.”
Governor LePage added that without knowing more details on the cost and nature of state-based exchanges, it is possible that our state could be placed in the untenable position of serving as the administrator of a new federal healthcare bureaucracy over which Maine has little control.
“Furthermore, many of the ACA regulations remain incomplete two and a half years after the bill passed. The legal status of portions of the bill remains unresolved, and there are too many unanswered questions. Complex technicalities make interpretation challenging, and unknown financial obligations—at a time when we face a fiscal crisis that we have yet to resolve—become extremely burdensome to businesses and families. Without such issues addressed, Maine cannot make a prudent and comprehensive decision in the best interests of our citizens.”
The Governor has also stated that the State of Maine will not expand Medicaid under the current structure that exists because it is not affordable.
Governor Paul LePage issued the rejection letter Thursday to arrive by Friday, Nov. 16, which is the deadline the federal government initially gave states to declare their intentions. On Thursday, HHS extended the deadline for states to make a decision on a state based exchange until Dec 14.
The full text of the letter is included below.
November 15, 2012
The Honorable Kathleen Sebelius, Secretary
Department of Health and Human Services
200 Independence Ave, SW
Washington, DC 20201
Dear Secretary Sebelius:
With the November 16 deadline for states to determine whether we will participate in the health care exchange program per the Patient Protection and Affordable Care Act (ACA) upon us, I am writing to make you aware of Maine’s decision. As you know, the State of Maine has had a number of concerns regarding the implementation of the ACA.
Because the guidance issued in the August 13, 2012 request of the U.S. Department of Health and Human Services (HHS) is not legally binding, the State of Maine will not be submitting a Declaration Letter. Instead, this letter serves as the state’s position regarding this issue.
Since the ACA was signed into law, the State of Maine, along with several other states, has repeated on a number of occasions and we continue to believe that the law has severe legal problems, is bad policy, and overreaches into the lives and pocketbooks of fellow Americans.
On November 14, 2012, I stated that our state would not build a state health insurance exchange as outlined by the ACA. We are not going to assist in implementation of this bill in its current form. The ACA is full of federal mandates; as such, even a state-based health insurance exchange is actually controlled by the federal government. In the end, a state exchange puts the burden onto the states and the expense onto our taxpayers without giving the state the authority and flexibility we must have to best meet the needs of the people of Maine.
Furthermore, many of the ACA regulations remain incomplete two and a half years after the bill passed. The legal status of portions of the bill remains unresolved, and there are too many unanswered questions. Complex technicalities make interpretation challenging, and unknown financial obligations—at a time when we face a fiscal crisis that we have yet to resolve—become extremely burdensome to businesses and families. Without such issues addressed, Maine cannot make a prudent and comprehensive decision in the best interest of our citizens.
We urge you to make public, as other states have requested, any contracts signed for the development of the federally facilitated Exchange. These documents would help states make informed decisions about the costs, timeframes, scope, operations and responsibilities of the federal exchange.
This law robs states of the ability to innovate and find cost-effective solutions that meet the needs of their citizens. We want meaningful reform, but the ACA masquerades as a free-market idea when in reality it is a stepping-stone to a single-payer system. Maine will not be complicit in the degradation of our nation’s premier health care system.
We need to address the real concerns of our health care system. I offer to work with your administration in finding workable, effective reforms and market solutions to the grave challenges we face.
Sincerely,
Paul R. LePage
Governor
cc: The Honorable Olympia Snowe
The Honorable Susan Collins
The Honorable Michael Michaud
The Honorable Chellie Pingree
Commissioner Mary Mayhew
Commissioner Anne Head
Superintendent Eric Cioppa
Stefanie Nadeau
