Maine DHHS denies applications for expanded Medicaid

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Denial letters have started to go out for Mainers applying for coverage under Medicaid expansion, according to documents and a progressive advocacy group that is suing the LePage administration.

The Mainers are eligible for Medicaid under a new law that was approved last year by voters, but the state has so far refused to expand the health insurance program that primarily serves low-income residents.

Gov. Paul LePage has blocked implementing Medicaid expansion, arguing that the Legislature did not sufficiently fund the expansion, despite voters overwhelmingly approving Medicaid expansion by a 59 to 41 percent margin in November, 2017.

A copy of an Aug. 7 denial letter from the Maine Department of Health and Human Services sent to a Caribou enrollee states the applicant is “not in a coverable category and is not eligible for full Medicaid coverage.”

Mainers could legally begin applying for coverage July 2, and the state had 45 days to deny or approve enrollees.

Robyn Merrill, executive director of Augusta-based Maine Equal Justice Partners, which lobbied for the 2017 referendum, said that it’s against the law to deny coverage, which is one reason why the nonprofit filed the lawsuit.

“They are in violation of the law,” Merrill said. “We plan to take all steps necessary so that Maine people can access health care sooner rather than later.”

The Maine Department of Health and Human Services did not immediately respond to a request for comment on Tuesday.

About 70,000 Mainers would be eligible for Medicaid under expansion, including low-income childless adults and parents.

Maine Equal Justice encouraged people to apply, but it’s not known how many people have applied for the coverage, although about 500 used the nonprofit’s online screening tool to see if they were eligible. Those earning up to 138 percent of the poverty level, about $34,600 for a family of four, are eligible for Medicaid. Those who earn slightly more than that can obtain inexpensive insurance through the Affordable Care Act individual marketplace.

LePage has consistently opposed Medicaid expansion, arguing that doing so would be financially disastrous for the state. In June, he said the Legislature’s $60 million funding bill for the expansion contained “unsustainable budget gimmicks,” and he vetoed it.

Merrill said if eligible people who applied were denied after an administrative appeal, Maine Equal Justice would file a separate lawsuit on their behalf.

The current lawsuit is pending before the Maine Supreme Judicial Court.

This story will be updated.

Mainers for Health Care rally outside the State House prior to Gov. Paul LePage’s State of the State address, Tuesday, Feb. 13, 2018, in Augusta. (AP File Photo/Robert F. Bukaty)

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