The toughest question, however, came from one of the people the governor believes he’s trying to help.

The governor parried inquiries from opponents wearing 61-percent stickers, members of the group Maine’s Majority. In doing so, LePage reiterated his administration’s commitment to a new energy policy and his desire to fold quasi-governmental agencies into state government. He also indicated that he was soon going to roll out a modified school-choice proposal.

LePage appeared comfortable when discussing those issues. However, he had more trouble when Lee Myles took the microphone toward the end of the 90-minute question-and-answer session.

Myles, CEO of St. Mary’s Regional Medical Center, first thanked the governor for attempting to repay the state’s debt to the hospitals. But Myles had some pointed criticism of LePage’s controversial budget proposal for the Department of Health and Human Services.

Myles, who runs one of the largest employers in the Lewiston-Auburn area, said the governor’s proposed reductions in Medicaid was a “nuke approach” that would remove health insurance for thousands of Mainers. The result, Myles said, was increased emergency room use that would have a $6 million impact on St. Mary’s. 

“I applaud your efforts to address Medicaid,” Myles said. “But this isn’t just a fiscal issue. It’s a moral issue.”

He added, “You didn’t create this crisis, nor did the Republicans or the Democrats.”

LePage told Myles he had no choice; federal Medicaid reimbursement rates were dropping. The state, he said, was broke.

“We’re spending fourth-quarter money and we’re in the third quarter,” LePage said. “Come April 1st, we’re going to run out of money.”

LePage, describing the DHHS budget gap as a “runaway train,” told the audience that if the Legislature didn’t ratify his proposed budget he would be forced to close the state’s schools.

The governor has floated that scenario before, although it’s unclear what authority he has to take such a measure. Nonetheless, the comment illustrates the urgency that the governor has attached to the DHHS budget, by far the most contentious issue he’s faced since taking office last year.

The DHHS cuts were on the mind of the audience, which mostly comprised the governor’s supporters. About a third of attendees were opponents.

The Medicaid cuts dominated the questions. LePage defended his budget, saying his initiative wasn’t a “cutting proposal,” but one that attempted to fix structural issues in the system. 

The nature of the DHHS shortfall remains a point of contention between the administration and Democrats, who speculate that the governor has amplified the crisis to advance a political agenda. So far, independent analysts have been unable to determine how much of the gap is one-time and how much is structural.

LePage on Thursday said some Democrats weren’t being truthful when they claimed he was overstating the funding gap. The crisis, he said, was real. He said Democrats’ expansion of Medicaid offerings and eligibility requirements made it so Mainers were shunning private insurance in favor of publicly funded health care.

The governor also repeated the claim that the DHHS budget gap was the result of ballooning enrollment. Democrats, meanwhile, cite the administration’s own analysis of the shortfall, which shows that DHHS officials under-budgeted for some programs and failed to account for the loss of federal funds.

Several audience members asked the governor what his plan was for those who would be left without health insurance.

LePage acknowledged that hospitals would see increased emergency room visits. However, he said he was working on a proposal that would require an individual to register with a primary care physician after his first emergency room visit. He added that changes in the state’s insurance laws would make private insurance more affordable to some of those who would be left without health care if his budget passes.

The governor also defended the tax-cut package he signed into law last session. While critics said that the cuts benefit the wealthy, LePage stressed the package benefited all Mainers, including about 70,000 of the poorest residents in the state.

“I’m proud of (the tax cuts); I’m not ashamed of it,” he said.

He added, “(The tax cuts) have nothing to do with the structural problems the state is facing now.”

LePage acknowledged that the cuts would be painful. However, he rejected what he described as “emotional arguments about welfare,” which he said, were “inappropriate.”

“We need a safety net that we can depend on,” he said.

The governor also indicated that he favored looking at other reforms for public assistance. He said that currently, personal income is the only eligibility requirement to receive benefits. LePage said an individual’s assets should also be a factor.

The governor’s comments were well-received by the majority of the audience, which often erupted in loud applause.

However, opponents took issue with the governor’s remarks.

Rep. Mike Carey, D-Lewiston, said it was no wonder that DHHS can’t give lawmakers a true assessment of the shortfall when “the boss keeps changing his story every day.”

Carey said LePage was attempting “to bully the Legislature” into passing his budget.

“First it was fraud, then it was people flocking to the state to get welfare,” Carey said. “Now he’s holding Maine school students hostage. It’s his timetable, his terms, his numbers.”

smistler@sunjournal.com