SOUTH PORTLAND (AP) – Republicans and conservative analysts say the state cannot afford to move forward with plans to enroll another 14,000 residents in MaineCare, the state’s Medicaid program.

Critics point to the perennial holes in Maine’s Medicaid budget, one of the state’s biggest-ticket items. This year, a shortfall forced the state to scale back rehabilitation to some brain injury patients.

The expansion is scheduled to go into effect on April 1, three months after the state’s new health insurance program goes into effect.

With the expansion, “what you end up doing is increasing the safety net but having holes in the net where the most vulnerable people fall through in order to enlarge the net,” said Sen. Carol Weston, R-Montville.

The Maine Heritage Policy Center organized the forum Thursday at the Marriott Hotel so national Medicaid experts and local lawmakers could talk about alternatives to Medicaid expansion with dozens of representatives of businesses, consumers and hospitals.

Government, for example, could offer Medicaid-eligible people subsidies to buy private coverage, speakers said.

And for the poorest Medicaid patients for whom subsidies are still not enough, a monthly cash allowance could be allotted to purchase services.

Nina Owcharenko of the Washington-based Heritage Foundation suggested larger-scale reforms for making health insurance affordable. Also recommended was a high-risk pool that would cover only the sickest populations and, thus, reduce premium costs for everybody else.

The Medicaid expansion of 14,000 people represents about a tenth of the people estimated to be uninsured.

It would encompass parents with incomes of up to twice the federal poverty level,($18,000) and single adults with incomes up to 125 percent of the poverty level, (about $12,000), said Trish Riley, director of Gov. John Baldacci’s Office of Health Policy and Finance.

Riley did not attend the event, but said she heard similar arguments during debates prior to last year’s passage of the Dirigo Health reform act, which incorporated the Medicaid expansion.

“It’s just different notions,” Riley said. “Our notion is that we’re all pooled together and when we get sick the money is there for us.”

AP-ES-10-01-04 1008EDT