AUGUSTA – In a late night session of the Maine House of Representatives, state lawmakers clung mostly to party lines in what some lawmakers called the biggest vote of the 126th Legislature.
Voting 87-57, the House Democrats overcame bipartisan opposition to pass L.D. 1546, An Act to Strengthen Maine’s Hospitals, Increase Access to Health Care and Provide for a New Spirits Contract. The bill, which passed the Senate 20-15, is a combination of Gov. Paul LePage’s hospital repayment plan and a Democratic proposal to expand Medicaid.
The evening began with House Speaker Mark W. Eves (D-North Berwick), in his first floor speech of the session, reiterating his conviction that expanding Medicaid, a welfare program known in Maine as MaineCare, is “morally” and “economically” right.
“We don’t just treat the symptom. We treat the problem,” said Eves.
Throughout the night House Democrats echoed the Speaker’s sentiments and shared several emotional stories as justification for expanding MaineCare. They also defended the linking of the two bills on the grounds that expanding MaineCare would prevent the state from accumulating future MaineCare debt.
Republicans objected to the process leading up to the vote, noting that no public hearing was held for L.D. 1546, and called Democratic leaders’ decision to link the bills “Pelosi-style politics.”
“I do not like being asked to pass a bill before I find out what’s in it,” said Rep. Heather Siriocki (R-Scarborough). “There is not one piece of public testimony for L.D. 1546,” said Sirocki.
She said expansion should not be rushed and that Mainers would benefit from a more measured approach. “It is in Maine’s best interest to take our time with Medicaid expansion,” she said.
House Minority Leader Ken Fredette (R-Newport) said Democrats’ all-or-nothing approach to paying the nearly half-a-billion-dollars owed to Maine’s hospitals and expanding MaineCare is a false choice.
“These items do not have to be put together,” said Fredette. Several Republican-led attempts to bifurcate the bills were defeated during the session.
Fredette said the Democrats approach to the two bills ignores the different timelines associated with paying the hospital debt on the one hand and expanding MaineCare on the other. While the clock is ticking on the hospital debt due to a federal matching formula, MaineCare expansion, which would not begin until January of 2014, is less urgent and deserves more thorough review.
Although Republicans made it clear that they would not necessarily oppose MaineCare expansion as a standalone bill, many expressed serious concerns about the long-term implications of such a decision.
“DHHS is already cannibalizing the rest of our government,” said Rep. Deb Sanderson (R-Chelsea), who serves on the Legislature’s Health and Human Services Committee.
MaineCare spending as a percentage of state General Fund spending has doubled over the past 15 years, increasing from 13 percent to more than 25 percent, according to DHHS statistics. Sanderson said that such uncontrollable growth in Maine’s welfare spending has crowded out funding for schools, roads, law enforcement and other critical government services.
While Democrats continued to tout a Kaiser Family Foundation study predicting a net financial gain for Maine under expansion, Republicans pointed to more recent DHHS estimates that expanding MaineCare will indeed hit Mainers’ wallets and pocketbooks when the tax collector comes knocking.
According to the latest numbers from DHHS, expansion would cost Maine taxpayers $70 million in FY 2016-17, $102 million in FY 2018-19, $150 million in FY 2020-21, and $75 million each year thereafter. The total cost for the first 7 years of funding 10 percent of the expanded welfare program will be roughly $400 million.
Even during the first three years – the so-called “free” period – the state will have to hire 93 new employees, complete with generous defined benefits packages, at a cost to taxpayers of $7 million per biennium.
Near the end of the night, Minority Leader Fredette offered an amendment to create a 13-member study group – 5 members of the Senate appointed by the President of the Senate, 5 members of the House appointed by the Speaker of the House, one member of the health care industry appointed by the President of the Senate, and one member appointed by the governor.
Fredette said the commission would consider how the lessons of Medicaid expansion in 2002 can be applied to the current debate.
“If we work together, we can come up with a solution that is best for the people of Maine. We can do this, but we need to do it together.”
Fredette said such a commission would represent the Legislature at its best, but Democrats disagreed, swiftly rejecting the amendment on party lines.
Although Democratic leaders congratulated themselves for a job well done, the bill is – and always was – destined for veto.
Rep. Kathleen Chase (R-Wells) summarized the good work the Legislature accomplished: “Two potentially good ideas that could have succeeded by themselves will instead die together,” she said.
The Democratic omnibus bill could reach the LePage’s desk late this week.