A simmering dispute among members of the Legislature's Appropriations Committee over a $37 million Medicaid waiver prompted Gov. Paul LePage to pay the panel an unexpected visit today. The governor told the panel that its debate over whether the waiver was permissible or not would be an issue he would straighten out at the federal level. LePage also told legislators that their failure to cut $221 million from the budget will force him to seek cuts to state education to close the gap.

While state Health and Human Services Commissioner Mary Mayhew responded to a Medicaid waiver question from Republicans and Democrats on the Legislature's Appropriations Committee, Gov. Paul LePage occassionally fidgeted in the audience.

Then Sen. Richard Rosen invited the governor to the speaker's table where LePage attempted to redirect the lawmakers' attention to a single point. "On April 1st, the state of Maine will default, it will not have money to pay the fourth quarter of 2012 Medicaid payments," LePage said.

That means Maine would have three full months left in the fiscal year. Under those circumstances, LePage told the Appropriations Committee he would be left with two options.

"I will be calling you back and asking you to give the GPA money so that I don't have to close nursing homes and we will probably close schools, " he said. "Or by Feb. 1st, you give me curtailment orders so I can start saving money. This is not normal politics, this not rhetoric."

What was irritating Republicans on the panel was a published report that Democratic Appropriations Committee members had asked the director of the federal Centers for Medicare & Medicaid Services whether the administration's plans to ask for a waiver from the Affordable Care Act were likely to be granted.

In her response, CMS Director Cindy Mann replied that to date no state's request for a waiver of the law has been approved. But Commisisoner Mayhew said the Democrats' letter to CMS was seeking an opinion on the question of a waiver which can be offered as part of an experimental, pilot or demonstration project, and that those plans have not yet been submitted by the administration.

"I don't think this letter is helpful," she said. "I think it was written in a speculative way and I think we received a response that is not in response to a specific proposal. The state of Rhode Island, their entire Medicaid program is under a waiver. Arizona is under an entire waiver. The use of the term 'pilot,' 'demonstration,'--I think it's all up to the secretary."

Some of programs being targeted by LePage are protected by a provision requiring waivers before they can be cut. Those programs represent $37 million of the $220 million in cuts the administration is proposing. Democrats are worried that they are being asked to sign off on a budget that may already have a $37 million hole in it.

Rep. Rotundo wasn't buying Mayhew's explanation. "There doesn't seem to be a fit--we aren't talking about a pilot project, we're not talking about a demonstration project," she said. "And they're clearly saying that those are the only things that waivers would be granted for."

LePage told lawmakers that they need to approve the budget and let him worry about convincing U.S. Secretary of Health and Human Services Director Kathleen Sebelius on the merits of Maine's plan.

"So I just urge you all to really get this done because I need to get to Washington and try to sit with the secretary and convince her that the decade of being overly generous, and the economy that we're facing, is such that they need to work with us," LePage said.

The Appropriations Committee members asked no questions of the governor and then recessed to party caucuses.