Inside Augusta

Progressives score hollow victory with Medicaid expansion committee vote


745px-MaineStateHouse1AUGUSTA – In a 5-7 party line vote, the Legislature’s Health and Human Services (HHS) Committee voted Monday to recommend passage of a Medicaid expansion bill, but the ‘nay’ vote of a key Republican lawmaker may foreshadow a momentum shift in the year’s most high-profile policy debate.

“It’s like we learned nothing from the last time we expanded Medicaid in 2002. Enrollment skyrocketed beyond projections, resulting in more than $700 million in hospital debt,” said Sen. Jim Hamper (R-Oxford), a member of the HHS Committee. “We just paid that debt off and now we want to go down that same road again,” said Hamper.

The present version of Medicaid expansion, L.D. 1487, was introduced by two Republican senators as a compromise measure. It includes the Democrat-sponsored Medicaid expansion proposal plus managed care legislation and a dubious “sunset” clause. The managed care legislation would cause the Department of Health and Human Services to outsource management of Medicaid enrollees to private companies, while the sunset clause would, theoretically, allow Maine to reduce eligibility for the welfare program in three years.

The committee vote allows Medicaid expansion legislation to move forward in the Legislature, but it is surely a hollow victory for Medicaid expansion’s proponents. Although Assistant Senate Minority Leader Roger Katz (R-Kennebec) and Sen. Tom Saviello (R-Franklin)’s compromise proposal was expected to lure more Republican votes, every Republican on the HHS Committee voted against the bill, including Rep. Carol A. McElwee (R-Caribou), who supported expansion last year.

McElwee’s position change is a devastating blow to pro-expansion Democrats and advocacy groups.

“I applaud Rep. McElwee’s decision and I thank her for being open-minded throughout the process in the face of new information and changing circumstances,” said Assistant House Minority Leader Alex Willette (R-Mapelton).

The debate over Medicaid expansion has become a hotly partisan issue since last year’s deliberations, with both sides debating fiercely about the proposal’s cost. Today’s committee meeting was no exception.

Last week, the Office of Fiscal and Program Review (OFPR) published  an analysis purporting to the show the cost of Katz’s Medicaid expansion proposal. Department of Health and Human Services Commissioner Mary Mayhew called OFPR’s cost estimate “nonsense” and blasted the policy analyst who crafted it for ignoring the cost figures provided by the department.

“I am concerned by the departure from the well-established process of using information submitted by the program area to inform decision-making,” Mayhew said in a press release. “The analyst clearly chose to ignore the facts and presented phantom savings that cannot be substantiated… One must question the motivation of doing so and the integrity of the process.”

Rep. Deb Sanderson (R-Chelsea), the Republican lead on the HHS Committee, asked the Democratic co-chairs of the committee today if Christopher Nolan, the OFPR staffer who crafted the controversial fiscal note, could explain his thinking. According to Sanderson, HHS Committee co-chair Rep. Richard Farnsworth (D-Portland) said that decision was up to Ana Hicks, chief of staff to Speaker of the House Mark Eves (D-North Berwick).

Farnsworth’s abdication of authority over his committee was a troubling sign for Sanderson.

“That told me clearly that the committee is taking orders from leadership and not making its own informed decisions,” said Sanderson.

The Katz-Saviello Medicaid expansion proposal could head to the Senate floor for a vote as early as Tuesday.

About Steve Robinson

Steve Robinson is the former editor of The Maine Wire and currently the executive producer of the Kirk Minihane Show. Follow him on Twitter @BigSteve207.

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