AUGUSTA – For the second time in the 126th Legislature, the Health and Human Services Committee held a public hearing on a proposal to expand Maine’s medical welfare program, known as Medicaid or MaineCare.
The vast majority of those present were organized supporters of L.D. 1578, the bill that would expand eligibility for Medicaid to tens of thousands of able-bodied adults pursuant to the federal Affordable Care Act, also known as Obamacare.
Gov. Paul R. LePage rejected the first attempt to expand Medicaid and the legislature failed by a slim margin to override his veto. Although Joint Legislative Rules do not allow reconsideration of bills that have already been rejected in a legislative session, House Speaker Mark Eves (D-North Berwick) choose to ignore the rules and allow a reconsideration.
In his testimony, Eves described the latest bid to expand Medicaid as a “compromise,” though it was not immediately clear whether this bill differs substantially from the last. Eves, who is the sponsor of the legislation, said a three-year sunset clause included in the bill is the compromise. But that provision was included in last year’s proposal as well.
David Sorensen, communications director for the House Republicans, told press reporters in an email that the current proposal is not a compromise at all.
“This is not a compromise bill; it’s the same exact thing we dealt with last year, LD 1066,” said Sorensen. He pointed to Senate Amendment “A” on that bill, which states, “This amendment repeals the expansion of medical coverage under the MaineCare program on December 31, 2016.”
“That’s the same exact sunset “compromise” the Democrats are recycling this time around,” he said. “To call this a compromise is grossly inaccurate and is simply feeding into the Democrats’ desperate attempt to manipulate the media in their favor as they see their dream of yet another disastrous welfare expansion for able-bodied adults slipping away.”
Compromise or not, supporters and opponents of Medicaid expansion packed the committee room to voice their opinions.
Jeff Austin, top lobbyist for the Maine Hospital Association, testified in favor of expansion. He said Maine’s hospitals were supporting the proposal because they have already suffered from Obamacare’s cuts to hospital payments.
Obamacare cut Medicare in order to fund other parts of the law, including Medicaid expansion. “From where we sit, those reductions are real,” said Austin.
Mary Adams, director of Maine’s center-right coalition and long-time tax reform advocate, opposes expanding Medicaid.
“We need a policy change,” said Adams. “But L.D. 1578 takes us in the wrong direction. She said expanding on the current system would effectively create two classes of health care, one for the rich and one for the poor. She said lawmakers should look to the private sector rather than government for health care reform. “I don’t believe that government has the answers in this case,” she said.
Joel Allumbugh, CEO of the National Work Site Benefit Group and director of health policy initiatives for MHPC, said lawmakers should be concerned about the cost and size of the expansion under consideration.
“We are radically underestimating the number of people this is going to cover,” he said.
He said more people will enroll in Medicaid than lawmakers are anticipating due to other provisions of Obamacare, especially mandates on small businesses with more than 50 employees. Many business owners will have to decide whether they can continue offering more expensive Obamacare-compliant plans over the next two years, and if they can’t, many of their employees could end up on Medicaid. “This is a cost-benefit analysis for employers,” he said.
Rather than expand Medicaid, Allumbaugh suggested the committee focus on the underlying cost of care.
Paula Sutton was one of the citizens who testified against expansion. She doubts whether the federal government will keep its promise to fund the majority of the cost of additional Medicaid enrollees. “After hearing, ‘if I like my plan, I can keep it,’ I just don’t trust them,” she said.
Today’s public hearing followed a presentation to the HHS Committee from Gary Alexander, president of the Alexander Group. Alexander, who has previously directed HHS Departments in Pennsylvania and Rhode Island, was one of the chief authors of a report examining Maine’s Medicaid program and the current expansion proposal.
According to Alexander’s report, Medicaid expansion could cost Maine taxpayers more than $800 million over the next ten years and will consume one half of the state budget by 2024. The report also suggests enrollment in the welfare program will skyrocket in the first two years to well beyond the 70,000 figure often invoked by Democrats.
The hearing also follows Monday’s news that the state is facing a $119 million budget shortfall, attributable mostly to cost overruns in Medicaid.
Senate Minority Leader Mike Thibodeau (R-Waldo) said the Medicaid shortfall was further evidence that Maine can’t afford expansion.
“Democrats want to put another 70,000 able-bodied Mainers on this program,” said Thibodeau.
“We are now going to have to find a way to fill this $119 million hole, and they want to dig it even deeper for us. Our Medicaid program is unsustainable as it is,” he said. “Expanding it now makes no sense.”
Editor, Maine Wire