AUGUSTA — It likely will take at least another three months for Maine to find out whether it can make $20 million in cuts to its Medicaid program.
A federal Centers for Medicare and Medicaid Services spokesman said Thursday the office has asked for additional information from Maine officials regarding the state’s request to cut Medicaid coverage to balance the budget.
The request for more information restarts the 90-day window the federal government is allowed for reviewing Maine’s application for an amendment to its Medicaid plan. The federal government originally was expected to rule by Thursday, three months after the state had submitted its amendment request.
The proposed cuts would affect 36,000 low-income people, eliminating coverage for 19- and 20-year-olds, tightening income eligibility requirements for low-income parents and scaling back Medicaid access for elderly residents who also qualify for Medicare benefits.
The LePage administration had been counting on the cuts — approved as part of two supplemental budget packages over the past year — to balance the current state budget. The cuts were slated to take effect Oct. 1. Now the cuts won’t take effect until early February 2013 at the earliest, and a newly sworn-in Legislature this winter likely will need to approve a supplemental package that finds another way to balance the current state budget.
It has been uncertain from the start whether many of the proposed Medicaid cuts are legal under the Obama administration’s Affordable Care Act, which largely prohibits states from cutting existing Medicaid services in advance of a 2014 Medicaid expansion. The section of the law prohibiting those cuts is called the “maintenance of effort” provision.
But Attorney General William Schneider told members of the Legislature’s Appropriations Committee last month that the U.S. Supreme Court’s June ruling on the federal health care law made Maine’s cuts legal. While the Supreme Court largely upheld the health care reform law, it ruled it was unconstitutional for the federal government to withhold funds for existing Medicaid services as a way to enforce the Medicaid expansion.
Schneider has called the “maintenance of effort” provision “part and parcel of the Medicaid expansion that was struck down.” However, U.S. Health and Human Services Secretary Kathleen Sebelius has said the Supreme Court decision doesn’t affect that section of the Affordable Care Act.
The delay of the federal decision on whether Maine can make its Medicaid cuts follows a summer legal tussle between the state and federal governments.
Schneider in early September filed a lawsuit with the federal First Circuit Court of Appeals in Boston to force the federal government to more quickly rule on and approve Maine’s request to scale back its Medicaid program. A three-judge panel threw out that lawsuit less than two weeks after Schneider filed it.
A LePage spokeswoman said a response to the federal officials’ request for more information is forthcoming.