By Ramona du Houx
The Appropriations and Financial Affairs Committee (AFA) met on December 13, 2017 to begin its review of the cost of implementing Medicaid expansion passed by the voters in November. Maine is the first state in the nation to expand access to healthcare under the Affordable Care Act via ballot initiative. The committee also reviewed the latest revenue projection forecast for the state.
But Governor LePage issued a statement declaring how the implementation would take place, which is not the normal procedure and could endanger equal opportunity to healthcare.
The LePage Administration and the Department of Health and Human Services are required by law to begin the process of expanding Medicaid eligibility to Mainers earning less than 138 percent of the federal poverty limit — roughly $17,000 annually.
The law includes strict deadlines for DHHS to act. However, despite an invitation from AFA committee co-chairs Rep. Drew Gattine (D-Westbrook) and Sen. James Hamper (R-Oxford) to the Department, LePage declined to send representatives from his administration the meeting.
“Thousands of Mainers cannot afford to wait any longer for the health care they need to be and stay well,” said Rep. Gattine. “And what we did today was to start the critical work necessary to make this law a reality. While I’m disappointed that Governor LePage chose not to send a representative, I can’t say that I’m surprised. Medicaid expansion is now the law of the land and our committee will continue to gather the facts, do our work and appropriate funds when they are necessary.”
The AFA committee is tasked with determining the state share of the cost of expansion and appropriating funding. Projections by the Legislature’s nonpartisan Office of Fiscal and Program Review (OFPR) indicate expansion will inject more than $525 million of federal funding into the state economy every year. OFPR estimated the state’s share of expansion costs at $54.5 million once the federal share drops from 93.5 percent in the first year to 90 percent in 2021. There is no accurate cost projection for the current biennium due to a number of unanswered questions from the DHHS.
However, it was made clear to the committee that the state would not need an additional appropriation to fund the state share until May of 2019. In order to determine whether the state will need to make any expansion-related appropriations during the current budget cycle, the committee asked further questions of OFPR and DHHS about the timeline for covering newly eligible Mainers, the additional staffing needs at DHHS to process applications, and projected savings.
“Today, we began the work necessary to fulfill the voters’ mandate and expand healthcare coverage to 80,000 Mainers,” said Sen. Cathy Breen, D-Falmouth, the lead Senate Democrat on the AFA Committee. “The law states that by July 2018, the state is required to begin offering Medicaid coverage to those newly eligible Mainers, so there’s a lot to be done. I look forward to the work, but am disappointed that no one from Gov. LePage’s administration accepted our invitation to participate in the work today. Implementation of this law is his responsibility and obligation as the chief executive of our state, and we expect him to fulfill it.”