Maine governor lays out demands for Medicaid expansion voters approved

by Nathaniel Weixel - 12/11/17 4:30 PM ET

An expansion of Medicaid in Maine must be paid for without raising taxes or tapping the state’s budget stabilization fund, Gov. Paul LePage (R) told the state Legislature in a letter Monday.

The letter reiterated demands that LePage first made in November, after voters in the state overwhelmingly passed a ballot initiative to accept the Medicaid expansion under ObamaCare.

The Legislature will meet this week to discuss ways to fund the initiative.

“While I remain adamantly opposed to the policy of expanding Medicaid because it threatens our state’s financial stability, the Legislature is allowing it to become law,” LePage said in the letter. “But I will not implement it without adequate funding.”

LePage, who is term-limited out of office next year, has previously vetoed five Medicaid expansion bills passed by the state’s legislature.

He said in the letter that the money appropriated by the Legislature must be based on estimates from the state’s Department of Health and Human Services (DHHS), not on estimates from the independent Office of Fiscal and Program Review.

Under ObamaCare, the federal government will pay for most, but not all, of the costs if a state chooses to expand Medicaid coverage. Maine will get an estimated $525 million in matching funds from the federal government.

In October, the DHHS estimated expansion would cost about $275 million from state fiscal years 2018 through 2021.

Those numbers are more than double what were estimated by the independent Office of Fiscal and Program Review (OFPR).

In fiscal year 2020, when the federal government will only pay 90 percent of the expansion cost, OFPR estimated the expanded coverage 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.

In the letter, LePage also said the funding must be ongoing without any “budget gimmicks” and that waitlists for services for the elderly and disabled people must be eliminated before he enacts any expansion measure.