AUGUSTA, Maine — Department of Health and Human Services Commissioner Mary Mayhew urged lawmakers Tuesday to take steps toward closing an estimated $220 million shortfall in her department, even as an independent review of the red ink remained unfinished.
The nonpartisan Office of Fiscal and Program Review has been working with DHHS to confirm the size of the shortfall and determine how much of the gap is due to one-time costs versus ongoing expenditures. The office stopped short Tuesday of confirming DHHS’ estimates to members of the Legislature’s Appropriations and Health and Human Services committees.
“We are closer, but we are still a ways off from having a good enough understanding to provide independent confirmation of the shortfall,” said Grant Pennoyer, director of the office.
His office doesn’t yet have a complete picture of assumptions built into the DHHS budget, Pennoyer said. For the last several years, problems with the state’s claims system have prevented regular reporting on what’s driving spending growth in MaineCare, the state’s version of the federal Medicaid program, he said. DHHS is working to provide that information but the office can’t certify spending projections or nail down which costs might resurface in the next fiscal year without it, Pennoyer said.
Mayhew reiterated her confidence in Gov. Paul LePage’s budget proposal, saying one-time costs represent nearly $20 million of the $123 million gap in this fiscal year. LePage’s plan to overhaul MaineCare to close that gap also anticipates a roughly $100 million shortfall in the next fiscal year.
Mayhew stressed the need to move forward with the governor’s proposal, saying MaineCare will run out of money in early April.
“What is troubling to me is we believe that you have the information around which to assess the shortfall,” Mayhew said.
LePage’s plan calls for tightening eligibility guidelines, eliminating services and repealing coverage for 65,000 recipients to bring MaineCare closer to national averages for public health benefits.
Democrats said Tuesday’s meeting highlighted MaineCare administration problems, such as the claims system, as drivers of the shortfall.
“So the solution shouldn’t be reduced enrollment,” said Rep. Mark Eves, D-North Berwick. “You shouldn’t change the engine when you need a tuneup.”
Eves also pressed Mayhew on the administration’s plan to secure a waiver from the federal government for several portions of the MaineCare proposal that violate a provision of the Affordable Care Act, including dropping 19- and 20-year-olds from the rolls.
LePage has said Maine has a better shot at a waiver if the Legislature first approves his proposed cuts.
Mayhew said the administration has received no correspondence from federal officials to that effect, but winning legislative approval before applying for the waiver will put pressure on the feds to issue one.
The Affordable Care Act prohibits states from making it more difficult for its residents to enroll in Medicaid, such as through stricter eligibility requirements, pending full implementation of the federal law in 2014.
House Speaker Robert Nutting called on both parties to work together to put the DHHS budget on a path toward solvency.
“Governor LePage has put forward a budget proposal that will accomplish what past administrations failed to do: fix the structural problems in the DHHS budget without raiding other parts of the state budget or relying on gimmicks such as raising cigarette taxes,” he said in a statement. “These ‘kick the can down the road’ approaches have done nothing to solve the structural budget problems within DHHS.”
The Appropriations Committee plans to meet again Wednesday, Thursday and Friday to discuss the DHHS budget.