Department of Health and Human Services’ MaineCare proposal criticized

Posted Jan. 25, 2011, at 8:57 p.m.
Last modified Jan. 26, 2011, at 6:13 a.m.

AUGUSTA, Maine — The Department of Health and Human Services is proposing to change the way disabled Mainers apply for MaineCare, the state’s name for Medicaid, in Gov. Paul LePage’s supplemental budget. On Tuesday, the plan drew fire from several groups saying it not only is unfair, but also may be illegal.

“We are very concerned about this and don’t think it will save a lot of money. In fact, we think it may be costly,” said Kim Moody, director of the Disability Rights Center. The proposal would affect only those Mainers who apply for MaineCare and have not had their eligibility determined in 45 days.

“These are among some of our most vulnerable citizens,” she said.

The proposal would allow the state more time to process MaineCare applications before it would have to provide benefits to those who also have pending applications for disability benefits from the federal Social Security Administration. Acting DHHS Commissioner Russell Begin said the proposal would move the 45-day trigger for coverage to 90 days and was designed to save the state an estimated $3 million.

But the change also could cost local welfare programs, opponents  said.

“The proposed change would be very harmful to municipalities and would have a significant impact on general assistance expenditures and the state general fund,” said Shawn Yardley, Bangor welfare director. He said close to half of the 2,700 adults and children on the city caseload would be affected by the proposed change.

“This proposal just doesn’t seem to make sense, either fiscally or certainly for the people that need this service,” he said.

Yardley said when a person is not getting MaineCare, they turn to local general assistance. The state pays for half the cost of local general assistance until a threshold based on the property value of a municipality is reached, then the state pays 90 percent of the cost. He said Bangor hit the threshold in October, just three months into the budget year.

“We have already seen more people on general assistance in Bangor in the first six months of this year than we saw in all of last year,” Yardley said.

The issue was discussed last year and rejected by that Appropriations Committee. Instead, the panel authorized some additional temporary eligibility workers to process MaineCare claims and reduce the number of claims that triggered automatic coverage on day 46.

Anna Hicks of Maine Equal Justice, an advocacy group for poor Mainers, said the change is not warranted and would pose a serious risk to vulnerable Mainers.

“This proposed policy change of doubling the wait time for folks we believe would put too many people at risk, serious risk,” she said.

Donna Yellin, a social worker at the Preble Street Resource Center in Portland, said her agency often deals with people who are seeking a disability determination and said they often are in need of medication and other medical help immediately.

“The sooner they get medical treatment for their disabling condition on the front end, then the more effective it is,” she said. “ It is critical for people to get care and treatment as soon as possible.”

The legality of the proposal also was questioned.

Leo Delicata, an attorney with Legal Services for the Elderly, said the provision was drafted improperly and would apply to all MaineCare applicants, which would not be allowed under federal law. He also believes the proposal may violate the maintenance of effort provisions of the federal Recovery Act. In return for improved matching rates for Medicaid under the act, the state cannot reduce its coverage under the program.

“What would the procedure be for us to ask an opinion of the attorney general on this?” asked Sen. Roger Katz, R-Augusta, a lawyer and a new member of the committee.

Sen. Richard Rosen, R-Bucksport, the co-chairman of the panel, said the committee would ask for an opinion.

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