Maine health officials to study Medicaid expansion

AUGUSTA — The state has agreed to pay $1 million to an outside consultant to evaluate Maine's Medicaid program and study whether it should be expanded under the federal health care overhaul, officials said Tuesday.

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Maine's Department of Health and Human Services signed the contract with the Alexander Group, led by Gary Alexander, former welfare chief in Rhode Island and Pennsylvania.

The consultant aims to address financial challenges facing Maine's Medicaid program, DHHS said. Part of that includes studying the short- and long-term impact of expanding Medicaid.

A spokeswoman for Republican Gov. Paul LePage says the governor remains concerned about the costs of the expansion and continues to seek greater flexibility in running Maine's Medicaid program, with the belief that a "one-size-fits-all" approach to health care doesn't always meet the needs of individual states.

"The welfare system needs reform to make sure it is financially stable, provides sufficient rates to providers to ensure access and is focused on good health outcomes for Maine people," said spokeswoman Adrienne Bennett.

Democrats, however, reacted with skepticism to the hiring of the consultant.

"What we don't want to see is another gimmick to deny and delay health care for tens of thousands of Mainers, including nearly 3,000 veterans," said Rep. Jeff McCabe of Skowhegan, the assistant House Democratic leader.

LePage vetoed a bill in June to expand Medicaid in the last session, but Democrats have vowed to try again to expand health care coverage to about 70,000 low-income residents under the federal health care overhaul.

The governor has said it's essential to address current Medicaid problems to ensure all of Maine's disabled and elderly residents have the care they need before expanding the program to more people.

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JOHN PAINTER's picture

Beginning in 2014

Beginning in 2014 Disproportionate Share Hospitals, will begin to experience payment reductions from the federal government.

Disproportionate Share Hospitals like Riverview Psychiatric Hospital in Augusta, are facilities states designate as receiving high volumes of people without insurance, Maine has identified its psychiatric hospitals as such, and the federal government though CMS provides Disproportionate Share funds to the state which then reimburses those hospitals for care which would otherwise go unfunded.

The reason for the payment reductions is because as more people are covered by private insurance (or Medicaid) as called for under the Patient Protection and Affordable Care Act a.k.a. Obamacare, there is less money needed for federal Disproportionate Share Hospitals.

For Maine, like the other states which chose not to expand their Medicaid program, local tax payers will begin to pick up the cost of care at their hospitals which receive Disproportionate Share funds.

By choosing to not expand MaineCare, Maine's government knowingly chose to shift the cost of care at hospitals receiving Disproportionate Care Hospital funds onto the backs of local tax payers. The overall cost of Maine's Medicaid program while significant, is more of a red herring. Understanding how and why 20% of the MaineCare beneficiaries drive 80% of the cost, and who profits is more important to understand.


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