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Maine Democrats Draw Line Over Medicaid Expansion
05/30/2013   Reported By: A.J. Higgins

Democratic leaders in the Maine Legislature are drawing a line over Medicaid expansion, saying they will not vote on repaying money owed to Maine's hospitals until the health care issue is resolved to their satisfaction. The new position comes on the heels of the Legislature's failure to override the governor's veto of a bill linking expanded health care benefits for 70,000 Mainers with the repayment of nearly a half-billion dollars in Medicaid debt to Maine hospitals. A.J. Higgins has more.

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Maine Democrats Draw Line Over Medicaid Expansion Listen
 Duration:
3:38

Democrats on Medicaid

Left to right, Sen. Troy Jackson, Rep. Jeff McCabe, Rep. Mark Eves, Sen. Justin Alfond and Sen. Seth Goodall.

Majority Democrats in the Legislature are down - but they're not out. After the Maine Senate failed this week to override Gov. Paul LePage's veto of a bill that linked repayment of the state's hospital debt to Medicaid expansion, Maine Senate President Justin Alfond prepared an alternative strategy.

"We're going to run the Medicaid bill alone, and we will have the repayment ready to go too," he says. "And when the Medicaid is successful, we will pay back the hospitals."

And they plan to do it quickly. The Legislature's Health and Human Services Committee voted 10-4 in favor of a bill that directs the state to apply to the federal government for expanded Medicaid benefits under the Affordable Care Act.

Meanwhile, a bill initiated by the governor's office to simply pay the hospitals - a proposal supported by both parties - will cool its heels in the Appropriations Committee until Democrats can get an affirmative vote on the Medicaid expansion plan.

Some Republicans are skeptical that Washington will deliver on its pledge to pay 100 percent of expanded health care benefits for three years, decreasing to 90 percent by 2020. Democratic House Speaker Mark Eves says those concerns have no basis in fact.

"What we do know is our federal partners have given very clear guidance to what the Department of Health and Human Services here in Maine needs to do, and that is fill out a form, put a stamp on an envelope and send it." Eves said. "We know what the answer is going to be. They just need to act and they're not acting."

Republicans are clearly unhappy with the new Democratic strategy, which draws a line in the sand over Medicaid expansion. Rep. Ken Fredette is the House Republican Leader.

"Is that where we're at now, is that we're going to run our bill and if we can't get what we want we're simply going to not run a bill to pay the hospitals?" he asked.

Fredette says the Democrats' divide-and-conquer approach undermines what should be the Legislature's duty to act in the best interests of all Mainers, and that's repaying the hospitals. It's a proposal supported by leaders on both sides of the aisle.

"So why don't you simply do what we can agree upon and then let's work on the issue that we don't agree upon?" he said. "And to me, I don't see that as a political issue, I see that as, really, an attack on the integrity of the work that we should be doing here."

As Democratic and Republican leaders prepared for a showdown over Medicaid expansion, both sides were staking out very different interpretations over what a May 24 letter from federal officials implies about the health care program. Although the letter confirmed that childless adults would tentatively be eligible for a 100 percent federal funding for three years, the 100 percent match rate doesn't apply to Maine parents already covered in the state budget with a federal match rate of 62 percent.

Democrats argue that information was already known to the LePage administration, but the governor says the letter proves the federal government wants to penalize Maine by not offering to pay $30 million in benefits under provisions that will be offered to other states. Maine Department of Human Services Commissioner Mary Mayhew agrees.

"For some states that have not provided the same level of coverage for parents, they are going to receive 100 percent federal reimbursement," Mayhew said. "Maine will not receive one additional cent for those parents under the optional expansion."

Democrats say they will take the Medicaid expansion bill up in the Maine House tomorrow.

Photo:  A.J. Higgins

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