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:
Katz and Saviello need to model Missouri, and practice some “Show Me.”
Read the list of “promises” they’re making, and ask them to PROVE IT.
“Promises” from this year’s legislature mean nothing next year, and they both know it. They cannot guarantee a single thing on their list of “promises” regarding the expansion.
By the end of the supposed three-year “sunset period,” new MaineCare recipients will have gotten settled with their new PCPs, and the liberals will fight against any sunset or program changes hoof, claw and tooth. The claims of “being mean to poor people” are already being printed on tee shirts and campaign signs. Once you give people this kind of freebie, there is no taking it back, no matter how many promises some people make now.
There will be no “sunsets” or changes to the program once implemented, except perhaps for FURTHER EXPANSION.
“Though details are vague, Katz and Saviello say their plan would also realize 5 percent cost savings in the Medicaid program, known here as MaineCare. It would use those savings to provide in-home and community services to thousands of mentally and physically disabled Mainers who are currently on waitlists.”
• A three-year sunset, meaning the expansion would expire when federal funding declines from 100 percent, and a vote by the Legislature would be required to continue the program.
• An automatic opt-out if the federal government reneges on its funding promise.
• The creation of a nonpartisan commission to monitor and study the expansion effort.
• Another commission, that would study ways to “transition people off MaineCare by finding sufficient employment.”
• A directive to the managed care organizations to work with current cost-saving DHHS initiatives.
• Additional fraud investigators for the Office of the Attorney General, to investigate and prosecute fraud by both consumers and providers of MaineCare service.
• Letters to every new MaineCare recipient, outlining the initial three-year limit on expansion of services and encouraging the beneficiaries to immediately establish a relationship with a primary care provider.
Who are Katz and Saviello trying to fool?
For Immediate Release, February 25, 2014
Contact: David Sorensen, (207) 205-7793
Communications Director, Maine House Republicans
House GOP Leaders Reject Katz/Saviello Proposal
Medicaid expansion a non-starter for Maine’s economic future
AUGUSTA – Maine House Republican Leaders on Tuesday rejected a proposal by Senators Katz and Saviello to implement managed care and Medicaid expansion simultaneously.
The proposal would expand welfare coverage to over 70,000 able-bodied, working-age Mainers at a cost of up to $125 million per year to hardworking state taxpayers while decimating the state’s ability to fund services for disabled Mainers, schools, and aid to municipalities.
“ObamaCare’s welfare expansion would be so devastating for Maine’s economic future that we simply cannot support it or anything that’s attached to it,” said House Republican Leader Ken Fredette of Newport. “We have reached many productive compromises with our Democratic colleagues over the past year, but Medicaid expansion will not be one of them—it’s too destructive of Maine’s economy.”
Assistant House Republican Leader Alex Willette of Mapleton added that under the leadership of DHHS Commissioner Mary Mayhew and the LePage Administration, cost savings initiatives are already being implemented in the MaineCare program.
“By implementing value-based purchasing and Accountable Care Organizations, Commissioner Mayhew and the LePage Administration have held Medicaid cost growth to about one percent over the past two years, compared to four percent nationally.”
“We acknowledge the efforts of Senators Katz and Saviello in trying to reduce health care costs with managed care, but these are things DHHS is already doing and things that should be considered apart from ObamaCare’s welfare expansion proposal,” added Rep. Fredette.
The Health and Human Services Committee will hold work sessions on various Medicaid expansion proposals Wednesday afternoon.
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