Republican Gov. Paul LePage says Maine can no longer sustain an array of Medicaid programs that are more generous than the national average and that sweeping budget cuts must be made. The governor wants to drop 70,000 people from the welfare roles to achieve $120 million in reductions in the current budget cycle. And he wants to make another $100 million in cuts beginning July 1st. Democrats say the governor's numbers are not solid and that they will oppose the current proposal.

Gov. Paul LePage says Maine's Medicaid enrollment has grown by 78 percent since 2002, and that there are currently more than 361,000 Mainers in the program. Decreasing that number down to 260,000 would bring Maine more in line with the national average in terms of per capita enrollment, and that's a goal that the state must strive to meet, LePage says, starting next year.

"We are proposing to be at about 290,000 to 295,000 people," LePage said.

LePage is proposing reducing state Department of Health and Human Services spending by $120 million dollars in the current fiscal year. He would then slash another $100 million dollars in the budget cycle that begins next July 1st.

Ultimately, LePage's plan would cut the welfare rolls by about 70,000 people, many--but not all--of whom are covered under plans that are not offered in other states. The governor says the state has run out of funding options and that he needs the Maine Legislature to embrace his proposal.

"We can kick the can down the road like the federal government is doing, and putting it on the state lap, or we can sit down, both the Democrats and the Republican party--the elected officials--and find a way to curb this spending," LePage said. "We have put together a proposal that we believe does not get us to the national average, because of the aged population we have, but it gets us closer, it gets us close to, like, 23 percent."

And the future looks even darker for MaineCare, the state's Medicaid program. LePage said the feds 75 percent reimbursment rate for hospitals has dropped to 63 percent -- and he fears that rate will continue to be reduced.

"If the federal government continues on the path they're going, they are dropping the reimbursement rate, and with the 'supercommittee' failing, and with the decision on LIHEAP, it's very possible and even likely that the reimbursement rate from the federal government will drop below 63 percent," he said.

"Over the years, the Medicaid program has lost its way," said state DHHS Commissioner Mary Mayhew. "It has grown exponentially in an effort to provide free health care to as many Mainers as possible. Maine has developed an unhealthy dependency on federal Medicaid dollars."

Mayhew blamed Maine's long history of dependence on federal health care incentives to offset the financial barriers that many poor Mainers face when trying to obtain health insurance.

The adminsitration's plan leaves no segment of the dependent population unscathed. Mayhew says that while the state has sought to minimize the impact of the cuts on the poor and disabled, they will nonetheless feel some of pain. Others who are simply working in low wage jobs will see their access to health care eliminated or restricted when eligibility standards are raised.

"Some of the eligibility groups that we are proposing to eliminate include childless adults, those healthy individuals who do nto have children that we currently provide coverage to, individuals who are 19 years old and 20 years old that we also currently provide coverage to within the Medicaid program, these are optional eligibility groups that are not required by the federal government, and Maine in many of these instances is an outlier compared to the rest of the country," Mayhew said.

"The governor himself when we met with him said the figures were unverified," says state Rep. Peggy Rotundo, a Lewiston Democrat. Rotundo says she and other Democrats are skeptical over the governor's projections for shortfalls at DHHS. As LePage's proposal is currently structured, Rotundo says Democrats will not suppport it.

She says Democrats would also like the LePage administration to lay their cards on the table if they can back up their claims about the budget gap at DHHS. "The commissioner of health and human services has not yet presented to us figures that have been substantiated, with regard to the ($120 million)," Rotundo says. "We have been asking for them for some time, we don't yet have them."

On the Republican side, Assistant House Majority Leader Andre Cushing, of Hampden, says that even if the numbers are slightly off, it won't be enough to avoid making the kinds of course corrections at DHHS that are recommended by LePage.

"Well, I certainly understand that they're taking a strong posture," Cushing says. "The numbers that we're talking about probably will change slightly, but the fundamentals that caused the problem will not get any better if we don't address them."

The governor said he would like to see the MaineCare changes passed by the Legislature next month.