Maine governor's refusal to expand Medicaid sets off new battle

Maine governor's refusal to expand Medicaid sets off new battle
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Maine Gov. Paul LePage’s (R) steadfast opposition to abide by overwhelming voter support of expanding Medicaid is likely to set off a funding battle when the state legislature meets early next year.

Estimates over the expansion cost differ wildly, and the governor has said he won’t approve a plan if it involves raising taxes or raiding the state’s rainy day fund.

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Backers of the expansion initiative, which voters approved on Tuesday, said they hope cooler heads will prevail once the legislature reconvenes in January. They believe that despite his defiance, LePage can’t succeed in blocking the expansion from happening.

But if the governor tries, expansion supporters said they will take him to court to force its implementation. 

“He can stall it, but the terms of the law call for him to implement [expansion],” said Christine Hastedt, public policy director for Maine Equal Justice Partners, a legal advocacy group. “Once there is a law establishing your right to benefits under the program, you have to provide it,” even in the face of a budget impasse.

“[LePage] doesn’t get to pick what laws he decides to observe and not observe,” Hastedt added.

LePage, a Tea Party Republican who is term-limited out of office next year, has previously vetoed five Medicaid expansion bills passed by the state’s legislature, arguing that such a move would be disastrous for the state’s economy. 

On Wednesday, he vowed not to expand Medicaid until the state finds a way to pay for it, a day after 59 percent of Mainers voted to expand the joint-federal health program. 

Under ObamaCare, the federal government will pay for most, but not all, of the costs if a state chooses to expand coverage.

LePage insists expanding Medicaid will financially ruin the state, and has relied on figures from the state’s Department of Health and Human Services (DHHS), which in October estimated expansion would cost about $275 million from state fiscal years 2018 through 2021.

Those numbers are more than double what the independent Office of Fiscal and Program Review (OFPR) estimated. Backers of expansion have also noted that the state will also get hundreds of millions of federal dollars.

In fiscal year 2020, when the federal government will only pay 90 percent of the expansion cost, OFPR estimated it would cost the state about $54 million. The DHHS said it would cost over $74 million.

LePage insists he won’t act until the state finds enough money to fund the higher estimate, and is throwing up roadblocks in terms of where that money should come from.

“I will not support increasing taxes on Maine families, raiding the rainy day fund or reducing services to our elderly or disabled,” LePage said in a statement.

Jesse Cross-Call, a senior policy analyst at the Center on Budget Policy Priorities, said LePage is  “putting down markers” that could further slow an already lengthy process.  

Under Maine’s constitution, a voter-approved initiative that requires the state to spend money will automatically become law 45 days after the legislature next convenes if there hasn’t been money appropriated.

The legislature convenes Jan. 3, 2018, so the expansion would become law in mid-February. The administration then has 90 days from that date to submit the required paperwork to the federal government, and a total of 180 days to start implementing the newly expanded coverage.

If everything happens according to schedule, newly eligible Medicaid beneficiaries won’t start getting covered until sometime in August, 2018.