Tens of thousands of Maine residents who could qualify for voter-approved Medicaid coverage face lingering questions on the expansion’s fate as a funding plan lacks the House Republican votes needed to override the GOP governor’s veto.
Lawmakers are scheduled to return Monday and face about three dozen vetoes from Gov. Paul LePage, who rejected Medicaid expansion funding legislation and called for long-term funding. The bill aims to ensure Maine can pay for its share of the expansion’s first year by providing up to nearly $55 million in one-time surplus and tobacco settlement funds in case of budgetary shortfall.
“This is all about keeping Medicaid expansion alive through the election,” LePage said on WVOM-FM.
“We could, in five minutes, if the leadership would sit down around the table, in five minutes we could take care of Medicaid expansion forever,” the governor said.
Advocates are suing to force LePage’s administration to seek federal funding for Medicaid as voters demanded last fall, and the next court hearing is July 18. Kathy Kilrain del Rio, policy analyst with Maine Equal Justice Partners, said LePage — who vetoed Medicaid expansion five times — has sowed confusion that could dissuade Maine residents who could benefit from expansion.
“It’s an amazing coordination of shifting the blame, passing the buck,” said independent Rep. Owen Casas. “To where the governor will be able to say: ‘They never gave me the money to do it’… He has his talking points, the Democrats have their talking points.”
Several House Republicans said they were lukewarm on LePage’s 11th-hour idea to raise hospital taxes, while they expected their caucus to sustain his veto.
“What happens with the first economic downturn? Do you have the same situation where the hospitals are being used as a credit card for the state like they were?” said Republican Rep. Lance Harvell, referring to hundreds of millions in hospital debt that accumulated following Maine’s 2002 Medicaid expansion.
Republican Rep. Donald Marean said he’s leaning toward overriding the veto because it would open the door to treatment for opioid abusers. “When you have 60 percent of the populace in favor of something, generally you ought to follow what they say,” he said.
States generally offset costs and save money after expanding Medicaid by using federal funds for care once provided by states, counties and localities, said Sara Rosenbaum, a professor of health law and policy at George Washington University. The federal government would eventually pick up 90 percent of Maine’s expansion cost, or over $500 million annually.
“At 90 percent, the financial advantage to a state from expanding turns out to be quite enormous,” she said.
LePage contends non-partisan estimates for first-year costs are low, that savings will be gradual, and that the current funding is a “gimmick.”
Maine began accepting Medicaid expansion applications on July 2. Under Maine law, applicants could gain coverage after 45 days, if Maine doesn’t determine whether they’re eligible.
LePage recently said his administration must interview applicants to prevent welfare fraud. But Thursday, a sign at the Department of Health and Human Services office in South Portland told MaineCare applicants: “Interviews are not required. In-person meetings are not available.”
An employee said applicants could receive temporary coverage after 45 days without clarity from courts or lawmakers. The health agency referred a request for interview with Commissioner Ricker Hamilton to LePage spokeswoman Julie Rabinowitz.
“I anticipate that some of this will become clearer when the law court issues its decision,” Rabinowitz said.