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Home ยป News ยป News ยป Partisan Politics Stall Hospital Debt Repayment
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Partisan Politics Stall Hospital Debt Repayment

Steve RobinsonBy Steve RobinsonMay 2, 20137 Comments6 Mins Read
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Democratic Leaders (left to right): Senate Majority Leader Seth Goodall of Sagadahoc, Senate President Justin Alfond of Cumberland, House Speaker Mark Eves of North Berwick, and Assistant House Majority Leader Jeff McCabe.

AUGUSTA โ€“ Republican and Democratic leaders held dueling press conferences on Tuesday over Gov. Paul R. LePageโ€™s proposal to pay nearly $500 million owed to Maineโ€™s hospitals and a separate Democratic proposal to expand Maineโ€™s Medicaid program.

โ€œPaying Maineโ€™s hospitals is incredibly important for our economy,โ€ said Senate Minority Leader Mike D. Thibodeau (R-Winterport).

โ€œIt seems just recently Maine Democrats put a new wrinkle in this agreement trying to attach the whole Medicaid expansion debate with paying Maine hospitals,โ€ he said. โ€œItโ€™s unfortunate.โ€

โ€œI would call on the Democrats to do what they know is the right thing to do and not try to change the rules midway through the game,โ€ said Thibodeau.

The governorโ€™s plan would use bonds taken against the proceeds of a renegotiated state liquor contract to pay $186 million for past Medicaid services, thus triggering $289 million in matching federal funds.

[RELATED: Baldacci says paying hospitals with liquor contract his idea…]

When the governor introduced his plan in January, Democrats accused him of playing โ€œWashington-styleโ€ politics by linking unrelated issues.

Thibodeau said, โ€œIโ€™m not sure you could refer to the Democrats latest move as anything other than Washington-style politics.”

โ€œThe Democrats need to stop moving the goal posts,โ€ he said.

graph-hospital-debt1
Credit: Bruce Poliquin

According to Republicans, Democratic leadership announced their intention to tie the hospital repayment plan to expanding Maineโ€™s Medicaid program at an April 24 meeting with legislative leaders and the governor.

Since that meeting, Democratic leaders have publicly walked back their demand that the two bills be linked, but they have yet to say definitively whether they will allow a vote on the governorโ€™s plan as is.

House Minority Leader Kenneth W. Fredette (R-Newport) said he thought there was bipartisan consensus that paying the hospitals with the governorโ€™s plan was the best route forward.

โ€œTo be surprised on Thursday with a demand form Democratic leadership that this be coupled with Medicaid expansion is very unreasonable,โ€ said Fredette. โ€œThere is no nexus between paying the hospitals and Medicaid expansion.โ€

He said LePage is attempting to negotiate the best possible deal for Maine before committing to expanding Medicaid.

โ€œI donโ€™t believe it is appropriate for the legislature to try to go in now and undercut the work heโ€™s trying to do,โ€ said Fredette.

[RELATED: Maine GOP points up dangers, unforeseen consequences of Medicaid expansion…]

Assistant Senate Minority Leader Roger J. Katz (R-Augusta) said Democrats were focusing on the short term benefits of Medicaid expansion, whereas legislative Republicans and the governor were interested in the long-term economic implications.

โ€œIf we were to pass Medicaid expansion today, Governor LePage has zero negotiating leverage with the federal government,โ€ said Katz.ย โ€œLetโ€™s give him the opportunity to negotiate the best deal we can for Maine. Maybe heโ€™ll fail, but he may succeed in saving us tens of millions of dollars.โ€

Katz said coupling the two bills together makes little sense and could impose dangerous spending commitments on Maine taxpayers in the future.

โ€œNot only do they not have anything to do with each other, it could end up costing us in the long run,โ€ he said.

According to Republicans, paying Maineโ€™s hospital debt will yield enormous economic benefits. In addition to injecting $500 million into the healthcare economy, paying the hospitals would also allow LePage to issue $200 million in general obligation bonds without putting Maineโ€™s credit rating at risk.

โ€œDemocrats are holding that up โ€“ $700 million into the economy today,โ€ said Fredette. โ€œDemocrats are stopping us from being able to put $700 million into the economy.โ€

[RELATED: Alfond: ย “We might have to stop paying the hospitals…]

Immediately following the Republican press conference, Democratic leaders, including Senate President Justin L. Alfond (D-Cumberland) and House Speaker Mark W. Eves (D-North Berwick) held a press briefing of their own to discuss hospital repayment, Medicaid expansion and the implications of an April 30 letter from Health Secretary Kathleen Sebelius.

According to Democrats, Sebeliusโ€™s letter signals that the federal government has compromised with LePage and will not penalize Maine with reduced funding levels for having already expanded Medicaid in 2002.

โ€œToday is a good day, I think, for the state of Maine,โ€ said Speaker Eves. โ€œWhat we know is that from the letter, communications from CMS, is that they will be covering 100 percent of newly eligible individuals that are going to be coming on to health coverage,โ€ he said.

Sources in the Governorโ€™s Office, however, said it is not at all clear that the letter means what Democrats have asserted it means.

Department of Health and Human Services Commissioner Mary Mayhew and two other DHHS staffers are currently in Washington, D.C. attempting to decipher exactly what the federal governmentโ€™s position is with regard to funding for individuals covered under Maineโ€™s earlier Medicaid expansion.

While Republicans believe there is no reason to connect hospital repayment with Medicaid expansion, Democrats insist the two issues are related.

โ€œTo not do these together would leave the job half done,โ€ said Eves. โ€œGood governance is about compromise. And these things have everything to do with one another.โ€

Said Eves, โ€œWe know that as we pay our final payment debt obligation to the hospitals itโ€™s been our position to make sure that we do something that really addresses the cost drivers in our health care system, so that weโ€™re not back here in this same spot. And we have an opportunity to accept these federal dollars to really address the cost drivers in our health care system and that is the charity care that the hospitals provide.โ€

President Alfond denied the Republicansโ€™ contention that Democrats have moved the goal posts on hospital repayment. He said the meeting on Thursday was productive, but that Republicans afterward decided to intentionally deceive journalists and the people of Maine.

โ€œWhat they took from that [meeting], is they started spinning this as reneging and offering threats and linking โ€“ I mean, come on, folks,โ€ said Alfond.

โ€œThis is just Republicans distracting all of you and the state of Maine from understanding why Republicans will not vote for expansion,โ€ he said. โ€œWhy will they not vote for expansion? Why is this not a good deal for the state of Maine?โ€

Said Alfond, โ€œI am completely just surprised that theyโ€™re going against the will of the people โ€“ itโ€™s an economic decision, itโ€™s a moral decision, and what theyโ€™re trying to do is spin this as, you know, this is one combined bill, are these multiple bills.โ€

โ€œWhat Mainers need to be asking Republicans right now is why they do not believe expanding health care in the state of Maine is not a good decision for individuals,โ€ said Alfond.

Alfond refused to say whether Democrats will allow LePageโ€™s hospital repayment plan to be voted on without being tied to Medicaid expansion.

โ€œWeโ€™re looking at all of our options right now,โ€ he said.

S.E. Robinson
Maine Wire Reporter
[email protected]

 

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Steve Robinson is the Editor-in-Chief of The Maine Wire. โ€ชHe can be reached by email at [email protected].

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