AUGUSTA – Republican Sens. Roger Katz (R-Kennebec) and Thomas Saviello (R-Franklin) on Tuesday released a draft of a “compromise” Medicaid expansion bill along with talking points designed to sell the measure to wary Republican lawmakers.
Katz and Saviello are expected to present their bill to the Legislature’s Health and Human Services Commission on Wednesday. Below are talking points and details of the bill.
The talking points, entitled, “A Republican Vision for Mainecare Expansion,” outline a bill that would both expand eligibility for MaineCare, as Medicaid is called in Maine, and order the Department of Health and Human Services (DHHS) to contract with multiple managed care service providers.
The document purports the bill to be a ‘silver bullet’ of sorts for Maine’s dysfunctional Medicaid program: “Through a robust stakeholder group process, thoughtful [Request for Proposal] document, and carefully crafted contract, we can ensure that managed care will be provided to our citizens in a way which will maximize access and health outcomes, provide timely and appropriate payment to health care providers, AND reduce cost and bring predictability to the budgeting process.”
According to the document, the bill would ask DHHS to contract with “three or four Managed care Organizations (MCOs) including at least one nonprofit, (such as a Martin’s Point) competing for enrollees statewide.”
According to the document, “The contract will also provide for a minimum 5% reduction in the cost for Mainecare compared to the projected cost in absence of managed care.”
Key provisions of the compromise bill include:
- Expanding Medicaid eligibility pursuant to the Affordable Care Act to individuals with incomes between 0 percent and 138 percent of the federal poverty line, as called for in House Speaker Mark Eves (D-North Berwick)’s Medicaid expansion legislation.
- A three-year sunset clause on expansion: “[O]ur participation ENDS when the Feds’ 100% reimbursement rate begins to decline. A New legislature, informed by good data (see below) would have to affirmatively decide to re-authorize coverage to the expansion population (see previous GOP amendment).”
- Ends Maine’s involvement with Medicaid expansion “automatically” if the federal government reneges on its 100 percent funding promise in the first three years.
- Increases co-pays from the current level (zero) to the “maximum allowed by federal law” to ensure Medicaid users have “more skin in the game”.
- Commissions an “impartial non-partisan study” before first three years of expansion conclude in order to assess the cost and benefit of “expansion experience”.
The above elements were contained in the Feb. 21 draft document. The bill, as released Tuesday, contains additional provisions, including additional fraud investigators for the Attorney General’s office and letter’s to new Medicaid enrollees explaining the “temporary” nature of eligibility expansion.
Here’s a copy of the bill: