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Maine Medicaid Changes Loom as State Awaits Federal Waiver
06/12/2012   Reported By: A.J. Higgins

State officials are banking on a waiver from Washington to eliminate some $13 million in services for the poor. The Legislature balanced the state budget by including the cuts, which are scheduled to take effect beginning Oct. 1. Some advocates for the poor predict the state will not be granted the Medicaid waiver, but the state is preparing for public hearings on the health policy changes.

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In a little more than 90 days, the reduction or elimination of health care services for about 27,000 Mainers is supposed to kick in under the state's recently approved supplemental budget. Sara Gagne-Holmes, of Maine Equal Justice Partners, says the impact will be felt across all age groups:

"Nineteen- and 20-years-olds, parents between 100 and 133 percent of the poverty level, and the Medicare Savings Program, which provides assistance to seniors and people with disabilities in order for them to access health care services, particularly medications," says Gagne-Holmes.

But before the state can start booking the estimated $13 million in budget savings, the Maine Department of Health and Human Services has to get a waiver from the federal Centers for Medicare and Medicaid Services. Majority Republicans in the Legislature, and the LePage administration, were sounding confident at the close of the legislative session.

But Democrats and advocacy groups for the poor, such as those represented by Gagne-Holmes, are skeptical. They say the federal government has refused to allow other states to reduce health insurance coverage for protected populations strictly for budgetary savings.

"We are of the position that these cuts are illegal under the Affordable Care Act and that the state of Maine can't implement them until they do get a waiver from the federal government." Gagne-Holmes says.

And before the state can get that waiver, state DHHS officials must meet new requirements designed to provide greater transparency to the process. In a recent letter from Maine Equal Justice Partners, DHHS Commissioner Mary Mayhew was reminded that the state must provide public notice and comment period, create a state Web site and schedule at least two public hearings on the waiver request.

Gagne-Holmes says the department should have been up to speed on the pre-conditions for the waiver request prior to receiving her agency's letter.

"We are confident that the department was aware of them, but we wanted to remind them that they are there because they are new, and also because we're very interested in learning the timetable so that we could weigh in from our clients' perspective," Gagne-Holmes says.

At state DHHS headquarters, Stefanie Nadeau, director of MaineCare Services, says she is still working with the federal Centers for Medicare and Medicaid Services to resolve some outstanding questions before public hearings on the programs can be scheduled.



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