AUGUSTA — Gov. Paul LePage has acknowledged that his proposed reduction of the state’s safety net will challenge the political will of state lawmakers. 

That may be an understatement.

One day after the governor revealed his plan to cut $220 million from the state’s Medicaid program, resistance from affected stakeholders continued to gather, setting the stage for an eventful slate of public hearings that will begin next week at the State House.

Democrats and advocates for the disadvantaged continue to question the math and motives of the administration’s proposal, including a provision that removes an additional $39.5 million from the general fund of the Department of Health and Human Services.

The $39.5 million goes beyond the $220 million the administration says it needs to address a recently discovered funding gap within DHHS. Administration officials say the additional cut will be transferred to the Maine Budget Stabilization Fund and could be reallocated if the department experiences another shortfall.

The proposal is drawing scrutiny from Democrats and advocacy groups. House Minority Leader Emily Cain, D-Orono, said it raises questions about whether the administration plans to use the funding to pay for additional tax cuts.

She added, “If that money is for DHHS, then how does putting money into the budget stabilization fund help that?”

Over the past several months, LePage has said he hoped to eliminate state income tax on retiree pension plans. That proposal would cost about $93 million, but like the tax cuts adopted by the Legislature earlier this year, funding it could be stretched over two years.

“I don’t pretend I can read anybody’s mind around here,” Cain said. “But the governor has been telegraphing for months that he was planning major proposals related to DHHS. And now we’ve seen it. He’s also been telegraphing more tax cuts, particularly related to pensions and retirees.”

Sen. Richard Rosen, R-Bucksport, co-chairman of the Legislature’s Appropriations Committee, declined to speculate on the reasons the administration would shift additional money out of DHHS. He said the money could be used during negotiations if lawmakers reached consensus on restoring other proposed cuts.

Meanwhile, the center of attention remains on the impact of the entire DHHS proposal. The cuts touch more than 30 MaineCare programs that are not mandated by the federal government, but that may receive federal matching money.

The administration argues that the cuts are needed to forestall future, inevitable DHHS shortfalls and to bring Maine Medicaid spending in line with the national average.

Opponents say the governor’s structural overhaul would have far-reaching and devastating consequences for the poor and elderly. Sara Gagne Holmes, who works for the advocacy group Maine Equal Justice Partners, said that while DHHS spending on those individuals would go down, the costs would be borne by private insurance holders as Maine hospitals see spikes in charity and emergency room care.

Gagne Holmes said that the governor’s welfare rhetoric also ignored the fundamental problem driving DHHS spending: lack of affordable health care.

LePage said this week that he hoped more affordable, private health care plans would be made available through the Legislature’s recent overhaul of Maine’s insurance laws.

Gagne Holmes said it was unlikely Mainers living near or below the poverty line would buy private health insurance.

Opponents of the governor’s plan are calling for more details in the cuts, as well as a mitigation strategy to address the 65,000 people that could lose MaineCare benefits.

The administration has identified a series of cuts, but it has yet to outline specific programs that would be affected.

John Martins, communications director for DHHS, said the department hoped to release more information next week.

DHHS Commissioner Mary Mayhew addressed the elimination of private, nonmedical provider funding, which opponents say would hurt elderly residents who have given up their homes but are not in nursing facilities.

Mayhew said Maine’s PNMI model has been under scrutiny by the federal government, which has threatened to withhold reimbursement.

“Since this is an optional service and the federal government has clearly expressed their desire for Maine to move away from this model, we have made the difficult decision to propose the elimination of all PNMI programs,” Mayhew wrote in a prepared statement.

Opponents are honing another argument against the cuts: job losses.

Garrett Martin, with the Maine Center for Economic Policy, a progressive advocacy group, said health care providers could be forced to shed positions that currently service Medicaid programs on the chopping block.

“There are parts of this state where the majority of the private-sector jobs are in health care,” said Martin, adding that Medicaid funding directly and indirectly supports about 40,000 jobs in the state.

Earlier this year, Arizona Gov. Jan Brewer began implementing a Medicaid overhaul that is similar in scope to the one LePage has proposed. While a comprehensive analysis of the impact has yet to be completed, news accounts have detailed increases in emergency room visits and health-care-provider job losses.

Those arguments and others will be heard by the Appropriations Committee, which will soon stage a major policy debate that could break along party lines.

The committee will begin drilling into the governor’s plan next Tuesday. Three public hearings will be held, beginning Wednesday.

[email protected]

Proposed DHHS cuts

* Health care for so-called childless adults (about 22,000 enrolled) and 19- and 20-year olds (about 7,000 enrolled).

* Reimbursement for independent providers of elderly and mental health care — so-called private, nonmedical providers (about 5,000 enrolled).

* Health coverage of about 20,000 parents with children covered by MaineCare.

* Eliminating the Medicare Savings Programs for low-income seniors (about 20,000 enrolled).

* Head Start program for impoverished children (about 5,000 enrolled). 

* Dental, occupational and physical therapy, adult family care and other services; limiting access to brand-name prescription drugs.

* The plan also cuts by more than 50 percent state subsidies for a Fund for Healthy Maine, which allocates money for a national settlement with tobacco companies for smoking prevention, prenatal and young children’s care, and prescription drugs for the elderly.