AUGUSTA, Maine — Senate Republican Leader Trey Stewart (R-Aroostook) is pushing new legislation aimed at tightening oversight of MaineCare, reducing enrollment among able-bodied adults without dependents, and forcing greater accountability from the state as concerns continue to mount over fraud, overpayments, and the program’s rising cost.
Stewart’s proposal comes as MaineCare remains under intense scrutiny after numerous fraud cases and millions of dollars in overpayments were uncovered, including $45.6 million identified in a recent audit by the U.S. Department of Health and Human Services Office of Inspector General.
At the center of the proposal is a required third-party independent audit of the MaineCare program focused on waste, fraud, and abuse. The legislation would also require the Maine Department of Health and Human Services to submit quarterly progress reports to the Legislature detailing its efforts to reduce enrollment among able-bodied adults without children and improve program compliance.
Under the plan, work and community engagement requirements would be imposed on able-bodied childless adults without dependents in compliance with the provisions of the One Big Beautiful Bill Act. The measure would also freeze enrollment for able-bodied, childless adults, with the total number of enrollees barred from increasing.
If lawmakers determine DHHS has failed to make meaningful progress, the Legislature would have the ability to impose additional program integrity measures to ensure compliance.
The proposal also seeks to address what Republicans say is a growing sustainability crisis within MaineCare. In the current biennium, the program will require nearly $170 million in bailout funding. Combined with last year’s bailouts, lawmakers will have plugged MaineCare with more than half a billion dollars during the current two-year budget cycle.
“MaineCare is the largest single item in our state’s budget and it only continues to grow. We must take steps to ensure the program can continue to provide services to those who need them most without requiring a massive bailout every legislative session,” Stewart said. “MaineCare has a serious sustainability problem. It’s incumbent upon the Legislature to rein in this program by both reducing fraud and making sure healthy adults on the program can better themselves and get off taxpayer-funded healthcare.”
Stewart also directly challenged Gov. Janet Mills (D) and Democratic lawmakers to support the measure if they are serious about addressing fraud in the system.
“The Governor and legislative Democrats have repeatedly claimed they take MaineCare fraud seriously. If that’s truly the case, they should have no problem supporting this proposal and allowing it to move forward,” Stewart said.
Sen. Marianne Moore (R-Washington), the Senate Republican lead on the Health and Human Services Committee, said the state cannot afford to ignore the financial and compliance problems surrounding the program.
“The legislative majority isn’t even thinking about how to make up for the tens of millions of dollars in Medicaid funds the federal government will likely be clawing back,” Moore said. “We must take action to protect MaineCare so it can remain available and accessible to seniors, children and those living with disabilities.”
