AUGUSTA — Department of Health and Human Services Commissioner Mary Mayhew told the Legislature’s budgetary panel Tuesday that she believes lawmakers have enough information to move forward with solutions to address her department’s $220 million budget shortfall. 

However, some lawmakers on the Appropriations Committee said they still want additional, independent analysis of DHHS numbers before acting on Gov. Paul LePage’s controversial plan to meet the budget gap.

That analysis, from the Office of Fiscal and Program Review, won’t be available for another two weeks, a time frame that concerned Mayhew. She told lawmakers that further study would be “helpful, but not necessary.” 

At times, Mayhew expressed impatience with the panel, a sentiment that may reflect the LePage administration’s feeling that lawmakers are dragging their feet. The additional time means that the governor’s opponents will have more time to highlight the effects of an unpopular proposal that would leave about 65,000 without health care.

It also means that lawmakers may finally get answers from the U.S. Department of Health and Human Services about the process required to obtain federal waivers from the Affordable Care Act. The waivers from the ACA’s so-called Maintenance of Effort provision are necessary to make about $37 million of the governor’s proposed Medicaid cuts legal. 

The governor has said that U.S. HHS Secretary Kathleen Sebelius told him the Legislature must first pass his budget to receive the waivers. However, the administration has since acknowledged that legislative approval isn’t a requirement but is designed to pressure the federal government.

On Tuesday, lawmakers quizzed Mayhew about whether legislative approval would carry additional weight with the federal government. Rep. Mark Eves, D-South Berwick, asked the commissioner why she was so sure legislative action would help.

“It certainly isn’t based on any written policy from (HHS), if that’s what you’re asking,” Mayhew said. “It’s about how we build the kind of pressure that will force them to consider our request.”

To date, only two states have applied for waivers, Arizona and Wisconsin. The Arizona request was denied; Wisconsin’s is still pending. 

Mayhew said more states might join Maine in seeking more flexibility in their Medicaid budgets. Other states have applied for a different type of Medicaid waiver. HHS has granted some of those.   

Meanwhile, Mayhew continued to express confidence that $19.7 million of next year’s $120 million budget gap was the result of one-time overruns. Lawmakers have been trying to get to the bottom of those numbers to determine how much of the shortfall was structural and potentially needed policy change.

Democrats have repeatedly questioned the credibility of the department’s assumptions and are wary that the figures were massaged to fit the administration’s policy goals.

The independent analysis by the Office of Fiscal and Program Review was designed to confirm the DHHS assumptions. On Tuesday, officials from the Office of Fiscal and Program Review stopped short of that confirmation, saying the department’s new claims system provided detailed information to pinpoint drivers in the shortfall, but not yet enough to forecast to the second half of the fiscal year. 

Fiscal review officials added that Medicaid claims were higher in the first half the year. That means that the DHHS numbers could be based on a higher claims rate than what might actually occur.

Mayhew said the analysis wasn’t required to move forward.

However, Appropriations Co-chairman Patrick Flood, R-Winthrop, said waiting for it could be worthwhile. 

Flood also referenced mounting political pressure for the committee to act. He urged committee members to continue to work toward a solution.

“Our single purpose is to pull something together even when there are other factors that would want to pull us apart,” he said.

House Speaker Robert Nutting, R-Oakland, issued a statement after the work session saying the independent analysis is “likely consistent” with numbers the administration put forward last month.

Nutting said it was now time to act. 

“Gov. LePage has put forward a budget proposal that will accomplish much of what past administrations failed to do: fix the structural problems in the DHHS budget without raiding other parts of the state budget or relying on gimmicks such as raising cigarette taxes,” Nutting said in a statement. “These ‘kick the can down the road’ approaches have done nothing to solve the structural budget problems within DHHS.”

 Democrats had a different take. 

“There continues to be disagreement over ongoing structural costs and one-time costs,” said House Minority spokeswoman Jodi Quintero. “Despite that, Democrats are ready to get to work on proposals that will fix these problems.”

Quintero noted that DHHS officials confirmed that the budget gap was driven by program administration shortcomings, not enrollment growth, as some have claimed. 

The Appropriations Committee is expected to meet Wednesday to further discuss the governor’s proposal. 

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