AUGUSTA, Maine — Legislators began to parse Gov. Paul LePage’s proposal to overhaul the MaineCare program Tuesday, but not with the haste the governor would like.
As members of the Appropriations and Health and Human Services committees held the first of two work sessions on the proposed Department of Health and Human Service’s supplemental budget, LePage took the unprecedented step of stopping by the session. The governor did not address the committees, but said during a break that lawmakers’ questions to DHHS Commissioner Mary Mayhew were unproductive.
“She sits there at the table, answers a gazillion questions, and none of them — none of them — will lead to the resolution of this problem,” LePage said.
LePage’s plan, designed to address an estimated $220 million shortfall in the DHHS budget, calls for tightening eligibility guidelines, eliminating services and repealing coverage for 65,000 recipients to bring MaineCare closer to national averages for the public health benefits.
Without his proposed reforms, MaineCare will run out of money by April 1, LePage has said.
The focus Tuesday was on whether the governor’s budget changes were viable given the fact that some of them violate federal provisions.
The governor expressed confidence Tuesday that portions of his MaineCare proposal that violate a provision of the federal health care reform law will be exempted. The Affordable Care Act prohibits states from making it more difficult to enroll in Medicaid, such as through stricter eligibility requirements, pending full implementation of the federal law in 2014. MaineCare is the state’s version of the federal Medicaid program.
“I’ve had some conversations with [U.S. Department of Health and Human Services Secretary Kathleen Sebelius] and I just believe that it’s not her intent, nor is it the [Obama] administration’s intent, to see any state go bankrupt or go broke,” he said.
LePage’s proposal violates the “maintenance of effort” provision in three areas: tighter eligibility for a program that helps seniors pay for prescription drugs, stricter income limits for some parents and dropping 19- and 20-year-olds from the MaineCare rolls, Mayhew told the committees.
Lawmakers questioned Mayhew and Assistant Attorney General Jane Gregory extensively on the prospects of Maine receiving a waiver, some voicing serious doubt about the state’s odds.
“How much of a gamble is there here?” asked Rep. Margaret Rotundo of Lewiston, the lead House Democrat on the Appropriations Committee.
Other states have applied for waivers of the provision, but federal officials have not yet approved any, Gregory said.
Mayhew said legislative action on LePage’s proposal would pressure Sebelius to respond quickly to a prospective waiver request.
“We do not believe that the maintenance of effort should be applied to the state … because we are not benefiting from any additional federal Medicaid support,” she said.
Little time was spent discussing the financial specifics of the governor’s proposed MaineCare cuts. Instead, lawmakers spent the first hours of the work session discussing fraud in the MaineCare system, though nothing in the supplemental budget addresses its fiscal effects.
“We’re trying very hard to understand the realities of the problem that do exist or might exist,” said Rep. Patrick Flood, R-Winthrop, co-chair of the Appropriations Committee.
DHHS, which implemented a new fraud hot line in October, received about 2,100 complaints of fraud last year, double that of the previous year, said Scott Fitts, director of the Fraud Investigation and Recovery Unit. Some of those complaints arose from misunderstandings about the program’s requirements, he said.
A task force is investigating fraud in the MaineCare system, with an eye toward preventing and detecting misuse.
The second work session on the DHHS budget is scheduled for Jan. 3, 2012.