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Maine Democrats Take Issue with Medicaid Expansion Report
01/10/2014   Reported By: A.J. Higgins

Expanding Medicaid in Maine under the Affordable Care Act would cost the state more than $800 million over the first 10 years, according to a Rhode Island consultant hired by the state. Gary Alexander, of the Alexander Group, predicts federal reimbursement will decline over the same time period, while Medicaid enrollment would double to nearly 600,000 people. Democrats say the report is engineered to support Gov. Paul LePage's plan to deny health care to thousands of needy Mainers. A.J. Higgins has more.

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Democrats Take Issue with Alexander Report Listen
 Duration:
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Gary Alexander in Augusta

Maine Department of Health and Human Services Commissioner Mary Mayhew had long suspected that expanding health care to an additional 70,000 Mainers would come with a huge price tag. But she says the report from the Alexander Group surpassed her wildest expectations.

"Nearly 100,000 new enrollees could join the program within the first two years," Mayhew said. "State costs will rise by over $800 million dollars."

For his part, Alexander (right) painted a bleak picture of Maine's future health costs if Democrats have their way and add more Mainers to the Medicaid rolls. Among Alexander's findings: The amount of federal Medicaid reimbursement has generally declined since 2000, a trend that is likely to continue.

But the big problem facing Maine and other states, Alexander says, is that even without Medicaid expansion, Maine's revenues are not projected to keep pace with the current year-to-year increases in MaineCare costs, which are running at about 6 percent annually.

Alexander said over the next 10 years, without expansion, state MaineCare costs are expected to grow from the current 24 percent to 36 percent - a figure he says would only be increased by expansion.

"Under the expansion scenario, MaineCare will take up about 38.7 percent of the state general fund, meaning without federal funds included, if we just look at state funds only, MaineCare will be at about 38.7 percent of the state budget," Alexander said.

And state costs aren't the only casualities under expansion. Alexander says with larger numbers of Mainers moving to Medicaid, the costs will be shouldered by a decreasing number of working Mainers.

"Right now we have 1.8 employed Mainers supporting one person on MaineCare," Alexander said. "If Maine were to expand, likely we would be looking at 1.3 employed Mainers by 2020 - so not even 10 years - 1.3 to 1."

Alexander's grim predictions are exactly what majority Democrats in the Legislature had expected. After Gov. Paul LePage awarded Alexander a $925,000 no-bid contract to study the state's Mediciaid system, they started probing the consultant's past.

They claim Alexander, a conservative Republican, introduced controversial cuts as welfare commissioner in Pennsylvania. Democrats also say Alexander presided over a mismanaged agency that cost taxpayers more than $7 million, and forced 80,000 children off state health care programs. Mark Eves is the Democratic speaker of the Maine House of Representatives.

"It's really no surprise to see the governor's tea party consultant - that the taxpayers paid a million dollars for - come out with this politically-driven report, and the people of Maine should see it for what it is, and that is, a political tool," Eves said. 'We should keep party politics out of making sure that we provide life-saving health care to 70,000 Mainers - including 3,000 veterans."

State Rep. Deborah Sanderson, a Chelsea Republican, says she's familiar with Alexander's work in Rhode Island and his track record speaks for itself.

"As far as his track record, if you're talking about what he's done to Rhode Island and what he's been able to do to help them have a global waiver, to help them be able to actually have the flexibility and the maneuverability in Rhode Island to target funds to keep folks in their homes longer, to be able to spend their tax dollars more wisely to help people, I think he's got a pretty good track record," Sanderson said.

View the full Alexander Report.
 
Photo: A.J. Higgins


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