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Medicaid Expansion Slowed by LePage Administration

The LePage administration is telling two key legislative committees that it will not take any steps to implement the expansion of Medicaid that was approved by voters until money is appropriated to pay for it.

Department of Health and Human Services (DHHS) Commissioner Ricker Hamilton outlined the administration's stance in a letter to the co-chairs of the Appropriations and Health and Human Services committees.

The co-chairs of the committees say the Medicaid expansion law requires that the department take several steps before it starts accepting new Medicaid applications July 1. The law requires that the DHHS file a formal Medicaid change plan with federal officials. The feds pay for roughly two-thirds of the cost of the existing program and the state pays the rest. The new law also requires the DHHS to write and adopt the rules to govern the expansion.

“This is the executive branch function, is to carry out the laws,” says Rep. Patty Hymanson from York, who co-chairs the HHS committee. “This is the law. This is their mandate. They need to do it.”

Westbrook Rep. Drew Gattine, who co-chairs the Appropriations Committee, says the department does not need additional funding to meet the requirements of rulemaking and filing changes for the Medicaid plan with the federal Centers for Medicaid and Medicare.

“We are going to have at some point appropriate more money, but we don’t project the Medicaid program running out of money because of the expansion until probably early June of 2019,” says Gattine.

Commissioner Hamilton could not be reached for comment, but Governor LePage has made it clear in a number of speeches and in his weekly radio address that he wants all the money needed to implement the program appropriated upfront before any steps are taken toward implementing the expansion.

“DHHS cannot hire and train the additional 105 staff need to run the expanded Medicaid program without the money,” says LePage.

Gattine challenges that claim. He says out of the $1.5 billion the state has already appropriated for the Medicaid program, there is enough to get the program up and running. Gattine also warns that if the Governor keeps blocking expansion, the matter will likely end up in the courts.

“If the Governor drags his heels, or digs in his heels and refuses to implement the law, that some of those people who have the right to have insurance and don’t have it are going to look at that law and say well I’ve got a right and l need to find a way to enforce that right,” says Gattine.

Both Gattine and Hymanson concede that there is little this legislature can do to force implementation of the law, as there are likely not enough votes to override an all but certain veto from the Governor.

Journalist Mal Leary spearheads Maine Public's news coverage of politics and government and is based at the State House.