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Senate Vote Leaves Future of Medicaid Expansion in Maine Uncertain
03/12/2014   Reported By: A.J. Higgins

A bipartisan plan to expand Medicaid coverage to thousands of Maine residents won strong support in an initial vote today in the Maine Senate, but fell two votes short of the majority needed to override a promised veto from the governor. As amended, the bill would allow Maine to take advantage of health care coverage under the Affordable Care Act. But it also contains an opt-out provision if the federal government fails to deliver promised reimbursements. Republicans oppose the plan on the basis of principle and costs. A.J. Higgins has more.

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Future of Medicaid Expansion in Maine Uncertain
Originally Aired: 3/12/2014 5:30 PM

For majority Democrats in the Legislature, Medicaid expansion under the Affordable Care Act is the signature issue of the session, and one that was staked out last year when it was narrowly defeated. After Republicans introduced a friendly amendment to the bill, Democratic hopes for bipartisan support were high.

But after lengthy debate in the Maine Senate, the bill only attracted two Republican votes. Most GOP members, such as Sen. James Hamper, of Oxford, blamed Medicaid expansion for creating a half-billion dollars worth of hospital debt that has only recently been paid off.

And Hamper warned against going back to those days.  "We're going to wind up not paying our bills, we're going to wind up in the same boat we just bailed ourselves out of," Hamper said.

Under an amended bill, sponsored by Republican Sens. Roger Katz of Augusta and Tom Saviello of Wilton - the only two GOP members who supported the measure - Maine would accept federal funds for Medicaid expansion for the three years the federal government pays 100 percent of the cost. Seventy thousand new Mainers would be covered under the plan that would also save the state more than $3 million a year.

The plan reduces the waiting list for homecare services for some elderly and disabled Mainers and strengthens the Health Care Crimes Unit in the Attorney General's office to investigate fraud. But other provisions, such as one that would allow the state to opt out of the ACA if the federal government failed to reimburse the state at promised levels, failed to galvanize the GOP. 

Instead, as Katz predicted, it opened the door for a Republican assault. "To mention the word 'expansion' around here is the political equivalent of throwing your gloves off at a hockey game - it's an invitation to brawl," Katz said.

And brawl they did. For more than three hours, Democrats and Republicans remained locked in their ideological struggle over the merits of the Affordable Care Act. At times, for Republicans such as Sen. David Burns, the debate turned personal as the discussion drifted into which Mainers are the most deserving of subsidized health care. Burns told his seatmates he has a 30-year-old son who was born with disabilities and cannot live on his own.

"He is one of the fortunate ones to now have many of the services that he needs to improve his quality of life," Burns said. "I know what he has gone through and I know what we have gone through while waiting for those supports. I can't impress on you enough how important it is to support this group of people before we move on to another 100,000. Please don't keep them locked out and put thousands of able-bodied people in front of him - it's just not fair."

Fears that the amended bill would simply allow more able-bodied Mainers to become government dependent became a common theme for Republicans during the debate. Sen. Rodney Whittemore is a GOP lawmaker from Skowhegan.

"To expand Medicaid under the federal rules would inflict a malignant cancer of dependency on thousands of Mainers who could otherwise provide for themselves under the exchange or private insurance," Whittemore said. "In too many cases this dependency erodes self-esteem, discourages responsibility and motivation, creates a feeling of entitlement and is a road to hopelessness."

Democrats fought back by asking Republicans to consider those less fortunate than themselves who have flooded the State House with appeals to enact the expansion bill. Sen. Colleen Lachowicz, of Waterville, said her seatmates who oppose the bill were choosing not to see the good it could provide.

"I will not be willfully blind to what is the essential truth in this bill - it will save lives," Lachowicz said.

Democratic Sen. Sen. Linda Valentino, of Saco, tried to appeal to the Republicans' economic interests. "The injection of more than $350 million in federal funds annually into the Maine economy will undoubtedly contribute to economic growth throughout the state," Valentino said.

The Medicaid expansion bill faces further votes in the House and Senate.



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