Maine’s Medicaid Expansion Battle Will Stretch Into October

Sep 29, 2018

Originally posted 12:53p.m. September 28, 2018.

The group suing the LePage administration to force it to expand Medicaid has withdrawn its motion seeking a third party receiver to take over the process of implementation. The development came at the end of two days of hearings in Superior Court in Portland.

Justice Michaela Murphy must decide whether the expanded health care program can start without any funds appropriated by the legislature.

Maine Equal Justice Partners filed the motion for a third party receiver after the LePage administration filed a federal application to begin the process of expanding Medicaid, per a court order. But that application doesn't stipulate July 2, 2018 as the start date for the program and for Robyn Merrill, the executive director of Maine Equal Justice Partners, that's a problem.

"Our primary concern was the effective date and wanting to ensure that we preserved the opportunity for people to get health care in the first quarter of coverage,” says Merrill.

Merrill says the July 2 start date follows a timeline outlined by law after voters approved Medicaid expansion last November. To avoid a third party receiver taking over implementation, Merrill says the state agreed to send a letter to the federal government that acknowledges the start date is the subject of a lawsuit.

"That submission mitigated our concerns, so our focus now is really on resolving this case in its entirety," Merrill says.

The larger case is about whether Maine can implement Medicaid expansion without dedicated funding. The legislature did pass a $60 million funding bill in June, but Governor LePage vetoed it.

The attorney who represents the administration in the lawsuit, Patrick Strawbridge, says funding is the key element needed to move forward.

"Without an appropriation that's been enacted into law, expansion can't proceed,” he says.

But Merrill says the administration is using that as an excuse, and that Medicaid can be expanded without dedicated funding. To back up that argument, Maine Equal Justice Partners called a former administrator for the Centers for Medicare and Medicaid Services (CMS) as a witness. Cindy Mann testified that budgeted state funding isn't needed for an application to be approved.

But Patrick Strawbridge cited examples that dispute that claim and tried to discredit the witness as a supporter of Medicaid expansion.

"Ultimately what they produced was a person who worked for the Obama administration, and who was an advocate for Medicaid expansion,” Strawbridge says. “Who, despite the fact that she apparently has expertise, had never seen the fact that the director of CMS has told other states that the ability to pay is in fact relevant to whether or not one should expand Medicaid."

At the end of the hearing Friday, the parties laid out a timeline to file briefs in the lawsuit that stretch through October. It's unclear when Justice Michaela Murphy will make a decision.

Medicaid expansion is estimated to cover about 70,000 Mainers; about 3,500 who would be newly eligible have applied since July and been denied.

Updated September 28, 2018 3:39 p.m.