Paul LePage vetoes Medicaid expansion bill

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Gov. Paul LePage vetoed a $60 million Medicaid expansion funding bill Friday, an expected move that sets up a veto override vote by lawmakers when they return on July 9.

LePage said in a statement Friday evening that he vetoed the bill, passed by the Legislature last week, because lawmakers acted in a fiscally irresponsible manner.

“We cannot allow bills to move forward that will harm the economy,” the governor said.

LePage’s veto came as advocates for the voter-approved expansion have been urging the 70,000 Mainers who may be eligible for the government-funded health insurance program to start signing up for it beginning Monday.

It’s not at all clear how long it will take for someone to actually obtain those benefits once they have applied for them.

A two-thirds vote of both houses of the Legislature will be needed to overturn LePage’s veto, and House Republicans have consistently stood behind the governor in his opposition to expansion.

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At the same time, LePage continues to press his legal appeal of a state court order that he file a plan for the expansion with the U.S. Department of Health and Human Services, which oversees the Medicaid program. The Maine Supreme Judicial Court will hold a hearing on the governor’s appeal on July 18.

Maine Equal Justice Partners, a nonprofit that advocates for the poor and was a primary backer of expansion, and other proponents are hosting a news conference Monday in Portland to promote enrollment. The organization also is setting up a hotline to field eligibility questions and developing a website to help people navigate the application process.

“We want to help Mainers understand that if they believe that they are eligible for health care coverage under Medicaid expansion, it’s important to submit an application to protect their right to care,” Robyn Merrill, the executive director of Maine Equal Justice Partners, said in a prepared statement Friday.

LePage said in a June 21 radio address that the Maine Department of Health and Human Services is not prepared to start taking applications from thousands of new Medicaid clients. He said that to “prevent welfare fraud,” DHHS must review each applicant’s records and conduct interviews to ensure the person qualifies for the program.

However, the governor noted that an applicant becomes entitled to full coverage if DHHS doesn’t complete its application review and make an eligibility determination within 45 days.

“This will force DHHS to simply deny all applications they don’t have time to review,” he said.

LePage also asserted that processing new Medicaid applications likely would result in other people who are currently eligible for other benefits under Medicaid, Supplemental Nutrition Assistance and Temporary Assistance to Needy Families programs to wait longer to receive those benefits.

And he contended that some of the Medicaid applicants would be eligible to purchase insurance on the Affordable Care Act health exchange, but they will give this up to get “free” health care from taxpayers.

But Kathy Kilrain del Rio, a policy analyst for Maine Equal Justice Partners, said that low-income Mainers and their advocates are not to blame for any shortfalls at DHHS, and the LePage administration has had ample time to prepare.

“This is not a surprise,” she said. “This date has been known since the law passed, the department has had plenty of time to prepare itself for the fact people would be eligible on July 2.”

Mainers can apply for Medicaid online at the DHHS website or by visiting an agency office. Applicants can also call 855-797-4357, press option 3 and then ask to be sent an application, which can be returned by mail.

Under the Affordable Care Act, the federal government shouldered a greater share of Medicaid costs, and states were encouraged to expand their programs with financial incentives.

The federal government initially picks up 100 percent of expansion costs, then lowers its share to 90 percent in 2020 and beyond.

Last week the Legislature passed a bill that provides about $60 million for the state’s share of expansion costs in the next fiscal year, which starts Sunday. That money would draw down federal matching funds of about $500 million a year.

Advocates for the program have said the health and financial benefits to the state far outweigh its share of expansion costs, but LePage and other opponents of expansion have said the state’s share of the costs could easily balloon to more than $100 million a year, which would jeopardize the state budget.

The governor has repeatedly said that expansion funding should include no new taxes on Maine families or businesses and should not tap into the state’s savings account, known officially as the budget stabilization fund.

The bill passed by the Legislature largely uses surplus state revenue and also draws money from the Fund for Healthy Maine, which is funded with tobacco lawsuit settlement money.

LePage said in his statement Friday that those funding sources were “unsustainable budget gimmicks” that will not cover Medicaid costs on a continuing basis.

“There are ways for the Legislature to fund Medicaid expansion in a fiscally responsible manner,” he said. “So I ask them to recall the bill and fund it properly.”

LePage’s statement said nothing about what a fiscally responsible funding method would be.

About 273,000 Mainers are already covered under Medicaid. The expansion would broaden eligibility to anyone earning less than 138 percent of the federal poverty level, or about $16,700 a year for a single person or $34,600 for a family of four.

Only 14 states have not adopted some form of an expansion plan under the Affordable Care Act, according to the Kaiser Family Foundation, a nonprofit that tracks health care issues. Maine is the only state to have approved expansion at the ballot box, after LePage successfully vetoed five expansion bills passed by the Legislature.

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