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LePage: Medicaid Expansion 'Bad for the Environment'
02/26/2014   Reported By: Patty B. Wight

The day after a proposed compromise to Medicaid expansion was unveiled by two Maine Senate Republicans, the LePage administration has launched a counter-offensive. The administration said today that "Medicaid expansion is bad for the environment." Commissioners from state natural resource agencies gathered with Department of Health and Human Services officials to make their case, as lawmakers were preparing to take up the Medicaid expansion bill this afternoon. Patty Wight reports.

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LePage: Medicaid Expansion 'Bad for the Environmen Listen
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Chandler Woodcock

Connecting Medicaid expansion to the environment may seem a stretch, but Inland Fisheries and Wildlife Commissioner Chandler Woodcock (above, at podium) says the tentacles of the expansion plan reach far beyond the realm of health care.

"The future of Maine is at stake in this discussion," Woodcock said. "And I know you hear the hyperbole all the time. But I'll tell you, I think for the natural resource arena and for Maine, this is the most important discussion that I've been a part of in my lifetime."

Even though the federal government covers 100 percent of the cost the first three years under the Affordable Care Act, the LePage adminstration doesn't believe that will result in enough savings from a healthier population to afford the expansion as federal coverage reduces to 90 percent by 2020.

Maine Department of Health and Human Services Commissioner Mary Mayhew says the state Medicaid program has already doubled in size over the last decade - in both enrollees and cost.

"That growth has come directly at the expense of other significant priorities, both within the Department of Health and Human Services as well as other critical investments in other state agencies," Mayhew said.

The two were joined at an Augusta press conference by Commissioner of Marine Resources Patrick Kelliher, who says his department has little to no funding to address serious issues, such as the shutdown of the shrimp fishery this season and the explosive growth of invasive green crabs.

"The idea of an expansion of this magnitude, the idea of doing it about anything in the future to address those issues, will be severely impacted," Keliher said.

All of the state's natural resource agencies, says the commissioner of the Department of Agriculture, Conservation and Forestry, Walt Whitcomb, have existed in the shadows of the Medicaid program's needs, suffering 13 million in cuts in the past five years.

"On the agricultural side, in '09, one of the last major shifts for Medicaid propping, the agency took a 13 percent in general fund spending cut - in one year," Whitcomb said.

But the argument that Medicaid is cannibalizing other state agencies - a term the LePage administration has used - is just plain wrong, says Democratic Senate President Justin Alfond.

"Ninety percent of the 'cannibals' are children, disabled people and the elderly," Alfond says. "So those are the cannibals, according to Gov. LePage and to all of his commissioners. Ten percent of Medicaid spending is for able-bodied adults - working poor adults of Maine."

Democratic Majority leader Seth Berry says, if anything, Gov. LePage's $400 million in tax cuts in 2011 are responsible for skimpy budgets.

"All of that money was given away in future biennia with absolutely zero plan to pay for it," Berry said. "Democrats warned that it was a time bomb and it was a bad idea."

Hours later, the Health and Human Services Committee considered the bill that's an attempted compromise to expand Medicaid. The key feature is moving Medicaid to a managed care program, while also expanding it.

Republican co-sponsor Sen. Roger Katz says managed care will control costs because outside companies will run Medicaid and receive a flat fee per patient, versus per service. And contracts will require at least a 5 percent reduction in overall costs to the state. Katz says it's time to let someone else run Medicaid.

"This department, and the previous administration's department, and the previous administration's department - nobody has been able to manage the system well," Katz said. "It's a string of problems - cost overruns after cost overruns after cost overruns."

But that's the very reason other Republicans in Augusta say it doesn't make sense to grow the program. Rep. Heather Sirocki points out that federal dollars are already available for those who need healthcare - at federally qualified health centers.

"There are 151 locations throughout the state. They offer free care, sliding scale, so depending on how much money you do make, you may have to pay a little," without the state of Maine, she says, being the middle man for that federal money.

The Health and Human Services Committee will take up the bill again on Thursday for a possible vote.

Photo: Patty Wight



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