Medicaid Expansion Battle Moves To Maine Supreme Court

Jul 18, 2018

The legal dispute over Medicaid expansion came before the Maine Supreme Court Wednesday afternoon.

Maine Equal Justice Partners and other consumer advocacy organizations are suing the state to force the LePage administration to implement the voter-approved law, and a lower court had ordered the state to file an expansion plan with the federal government. The administration appealed, arguing before the court that it can't implement expansion or comply with the order without funding.

Funding has been the central issue with Medicaid expansion politically in Maine, and it's the central issue before the state Supreme Court. The court must decide whether a temporary stay on a lower court order should remain in place.

The problem with that order, Patrick Strawbridge, the attorney representing the LePage administration told the justices, is that it requires the state to file federal paperwork to implement Medicaid expansion, and by doing so, forces the state to pay for a program to which it has not allocated funding.

"The appellees in this case seek to enforce an extraordinary order, requiring the commissioner to make a binding a commitment to the federal government that would obligate the state to spend 50 million dollars in this fiscal year alone."

Strawbridge argued that the state should not have to comply with the lower court's order because it's appealing the larger lawsuit and, he contends, there's a strong likelihood it will succeed.

“Because the initiative did not include a funding mechanism, it was widely understood and specifically disclosed to voters that further implementing of appropriations would be necessary to carry out Medicaid expansion."

In other words, voters may have passed Medicaid expansion, but the legislature hasn't allocated funding, meaning the hands of the administration are tied.

Robyn Merrill is the Executive Director for Maine Equal Justice Partners. Maine Equal Justice Partners and other consumer advocacy organizations are suing the state to force the LePage Administration to implement Medicaid expansion
Credit Patty Wight / Maine Public

That's an argument that James Kilbreth, the attorney representing the lead plaintiff in the lawsuit, Maine Equal Justice Partners, disputes.

"For them to argue now that, 'Oh, there's no appropriation' is a wholly self-inflicted problem,” says Kilbreth.

Last month, the legislature passed a bill to fund Medicaid expansion, which Gov. LePage vetoed. Kilbreth told justices that the state hasn't made any attempts to comply with the voter-approved mandate.

"If you have no remedy for the executives flagrantly disregarding the mandate of the statue, that's a problem."

But justices questioned whether it's appropriate for the court to insert itself on a government funding issue. Particularly, said chief Justice Leigh Saufley, when there's a question as to whether the state has the necessary funds.

"What we have here is a question as to whether there is funding available for the program that people say must be implemented,” says Saufley. “When you invoke the third branch to implement that, don't we have to know what the status of funding is?"

That's a question the state justices will decide.

Meanwhile, it's unclear how much the fight in courts is costing the state. According to data from the Legislature’s nonpartisan budget office, Gov. LePage spent more than $93,000 on attorneys for unspecified purposes during the fiscal year that ended June 31. However, that figure appears to reference one specific case, and not the costs of the current Medicaid expansion case or another that challenges the governor’s ability to withhold budgeted funds for the state’s public campaign finance program.

Steve Mistler also contributed to this report.