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LePage Administration Moves Forward with Request for State Cuts to Medicaid
08/01/2012   Reported By: A.J. Higgins

The LePage administration is moving forward with its request for federal approval of about $20 million in Medicaid program cuts that are already built into the state budget. Critics of the proposal claim the reductions will affect more than 25,000 Mainers, including the elderly, families and those with disabilities. The administration said its proposed amendments to the state Medicaid plan are consistent with the intent of the recent U.S. Supreme Court decision upholding the flexibility of each state to manage its own Medicaid program.

Nearly $20 million dollars in Medicaid program reductions are scheduled to be phased in under the state budget in just over 60 days. State Department of Health and Human Services Commissioner Mary Mayhew is hoping for an answer from the federal government before that deadline arrives.

"Earlier today, I submitted Maine's Mediciaid state plan amemndment request to the regional office of the Centers for Medicare and Medicaid Services," Mayhew said. "In this submission, I requested approval of this amendment request no later than September 1st."

But in the event that CMS denies the request, Mayhew says the state will seek reductions elsewhere in its Medicaid program. Then, Maine Attorney General Bill Schneider says the state will challenge the ruling in federal court.

"If we have to we would file a lawsuit, I think it would likely go either to the federal district court here in Maine or the First Circuit in Boston," Schneider said.

The budget cuts that would eliminate or reduce Medicaid eligibility for 14,500 low-income parents, 7,000 19 and 20-year-olds and coverage for over 5,000 seniors and people with disabilities enrolled in the Medicare Savings Program. The cuts were built into the budget as part of a waiver request to the Centers for Medicare and Medicaid Services. The budget envisioned an exemption under the so-called federal maintenance-of-effort, or MOE, requirement that Maine agreed to when it accepted enhanced Medicaid matching funds three years ago under the American Recovery and Reinvestment Act. Although Maine's current budget law specifically predicates the budget cuts upon acceptance of the federal Medicaid waiver, Mayhew says the amended plan accomplishes the same goal through different language.

"The law that's in effect in the budget was really focused on you can't implement this until you receive federal approval," Mayhew said. "The vehicle through which we receive the federal approval at the time was viewed as a need for an exemption from the MOE. The bottom line is the Legislature has instructed that we cannot act until we receive federal approval. We are pursuing the submission of a state plan amendment to get get the federal approval that the state now needs."

"We still maintain that they don't have the authority to do this," said Rep. Peggy Rotundo.

Lewiston state Rep. Peggy Rotundo has questioned the legality of the administration Medicaid cuts since the first day she heard about them. Like other Democrats, she is concerned about the impact the reduced eligibility requirements will have on the thousands of Mainers who rely on the state program for their health care needs. She questioned Mayhew's justification for the Medicaid reductions on the basis that they were necessary to balance the state budget. Rotundo said that what Mayhew didn't tell the feds was that majority Republicans built a half-billion dollars worth of tax cuts into that same state budget before making health care changes affecting more than 25,000 people.

"So what we're talking about is cutting drugs and health care to seniors and the disabled in order to help finance a tax cut that's primarily going to the wealthy in this state," Rotundo said.

Mayhew and Schneider are confident that the Centers for Medicare and Medicaid Services will approve the administration's amended plan that they say continues to offer a significantly higher level of coverage than what is required by the federal government.

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