Analysis: DHHS budget compromise patched for the moment

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AUGUSTA — With its preliminary approval by the Maine House of Representatives on Tuesday, one would think the Department of Health and Human Services budget compromise was still intact.

And it is, but not before it wasn’t.

The proposal that is expected to come out of the House on Thursday likely will look a bit different from the plan that received initial approval Tuesday. That’s because behind the scenes, the deal was breaking apart.

Republican lawmakers are still poised to reject Gov. Paul LePage’s calls for deeper Medicaid cuts for fiscal year 2012, though the GOP still isn’t ultra-thrilled with the idea of spurning the governor. However, given the immediate need to close the budget gap and the quick resolution provided by ratifying a budget with two-thirds — and Democratic — approval, the GOP appears willing to irk LePage now while delivering most of what he wants to Medicare in 2013.

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What the party isn’t willing to do, apparently, is tick off the Maine Heritage Policy Center.

Last week, amid the aftermath of the budget deal reached by the Appropriations Committee, the conservative advocacy group released a terse reaction to the compromise. The group’s ire centered on the plan to stop the scheduled drawdown of the Dirigo Health insurance assessment, fees assessed on insurance providers to fund the state’s affordable health care program.

Fights over the Dirigo assessment are legendary. In 2010, the Republican Party ran political ads calling it a “baby tax” because, it argued, increases in the surcharge were being passed along to patients who had surgery or babies.

Last year, the new Republican majority passed legislation to draw down the Dirigo assessment. The budget deal reached last week, however, would have halted that reduction in order to keep certain low-income individuals eligible for MaineCare.

But the statement by the Maine Heritage Policy Center, which holds considerable influence with the Maine GOP, threatened that plan. The group, referring to the assessment as a tax, said it was an “outrageous dereliction” of the voter mandate that swept Republicans into power in 2010.

Since then, Republicans have been meeting with Democrats, seeking a way to continue the drawdown of the assessment. Democrats threatened to walk if that meant eliminating more health care coverage.

The push-pull continued all day Tuesday. By the end of the day, people close to the negotiations said both sides had reached a deal that would continue the assessment reduction while retaining the health care coverage levels in the original compromise. Apparently, lawmakers also figured out a way to increase Medicaid reimbursement rates for the hospitals, too.

So how are they paying for all this? That’s not clear.

Specifics should be included in a budget amendment that will likely come from the House floor. That was supposed to happen Wednesday; however, Republican leaders Wednesday morning suspended the budget vote until Thursday.

That likely means lawmakers are still trying to find common ground on how to pay for the compromise. If they reach it, the budget should come out of the House on Thursday, assuming the deal doesn’t fall apart before then.

smistler@sunjournal.com

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