AUGUSTA, Maine — Lawmakers spent more than two contentious months wrangling over the details of a supplemental budget designed to address a massive shortfall in the Department of Health and Human Services.
Still, when that budget finally passed last week, it did not signal the end of the Legislature’s budget work this session.
Far from it.
The $150 million budget signed into law by Gov. Paul LePage last Thursday pays DHHS’ bills only through June 30. It also includes savings in other state departments identified last summer by a budget streamlining task force.
The governor’s initial DHHS budget proposal released in December addressed both the 2012 and 2013 fiscal years, but the Appropriations Committee opted to focus on 2012 first.
That means they will be back at work this week crafting a budget for 2013 that needs to close an estimated $85 million hole in DHHS — a process that promises to be no less challenging and every bit as partisan.
“We have a complex mix of moving parts,” said Rep. Kenneth Fredette, R-Newport, a member of the Appropriations Committee. “We all understand that there’s difficult work ahead but I’m open-minded to think we can fashion something that works.”
House and Senate Democrats cast just enough votes to ensure passage of the 2012 DHHS supplemental budget, but they likely will be less eager to compromise now.
“There are so many leftover things that are nonstarters for our caucus, cuts that are so severe and so harmful to the vulnerable,” said Rep. Peggy Rotundo of Lewiston, the lead Democrat on the Appropriations Committee. “Other cuts would shift costs to local communities, which will increase property taxes, and others would increase health insurance costs for private insurance providers.”
Gov. LePage proposed an initial supplemental budget that cut $220 million from DHHS for 2012-13. What was proposed by the governor caused heartburn for many lawmakers. When it became clear that there would not be agreement on a supplemental budget for two years, the Appropriations Committee broke it into two pieces.
Most of the controversial elements of the governor’s original proposal were stripped from the budget fix passed last week, but those pieces are now on the table.
A fundamental divide remains between Democrats and Republicans about the role of MaineCare, the state’s Medicaid program.
Gov. LePage and many House and Senate Republicans have said the state’s publicly funded health care system is unsustainable and needs structural changes in order to survive. Many Democrats say structural change is code for kicking people off MaineCare and that’s not something they are comfortable with.
“We do see this as a removal of people from health care,” Rotundo said. “We feel there are ways you can reform MaineCare and reduce costs without taking services away. That’s what we’ve focused on and will continue to focus on.”
The 2012 budget that recently passed needed a two-thirds majority in the Legislation so that it could be enacted as emergency legislation and go into effect immediately.
The 2013 budget doesn’t need to go into effect until July 1, so likely does not need a two-thirds majority. With a simple majority, the budget would become law 90 days after the end of the legislative session, which is scheduled to run into April.
Rotundo said the leftover pieces of the DHHS supplemental budget include three elements totaling $37 million in savings that would require federal waivers. She said Maine has been told those waivers are unlikely, but LePage has pledged to fight for them anyway.
There is also likely to be another supplemental budget from the governor that addresses the remainder of state government outside DHHS. Rotundo said her preference would be to roll that into the 2013 DHHS budget, but LePage and legislative Republicans have been less receptive to that idea.
“I think it’s too early to tell whether we’ll do that, but we haven’t seen the overall supplemental yet,” Fredette said.
One thing is certain: There isn’t a lot of time to get this done. The end of the session is set for April 18.
Kicking folks off MaineCare isn’t going to make their illnesses and injuries go away. They will still get treatment from ethical Hospitals and those hospitals will be reimbursed by those of us that are lucky to have insurance. Yep we all pay no matter whether it’s via a Mainecare program or our own insurance. So where’s the savings? There aren’t any. Actually LePage’s plan will likely cost us more in EMERGENCY care rather than preventive care. The only thing “good” (If one can call it that) about Mr. LePage’s plan is that it stirs up a certain segment of the public who would rather talk about hurting/not helping anyone but themselves than saving themselves money in the long run. Health wise stupid, economically stupid, politically stupid as well, but it sure gives folks something to fixate and whine about…while Paulie is busy doing mischief elsewhere. Want to get people off Mainecare? Create some freaken jobs for people who aren’t named LePage!
So the way we’ve done it for 40+ years is the answer???
“We feel there are ways you can reform MaineCare and reduce costs without
taking services away. That’s what we’ve focused on and will continue to
focus on.”
So where was Peggy Rotundo’s concern for reform when the Dems were totally in charge for the last 8 years?
DHHS used to be able to add and subtract then. It’s funny how the budgeted money has remained somewhat level over the last 6 or 7 years, we get one year of this guy…..BOOM!! a 220 million dollar shortfall. Strange ain’t it?
Yeah it was easier under Baldacci. DHHS just didn’t pay their bills ($350,000,000 still owed to hospitals and health care providers). Funny how you can make a budget look balanced by not paying your bills. You should try that yourself and let us know how it works out for you.
If that’s was the case, and I don’t think that it is, then why wasn’t this amount included in LePage’s shortfall numbers? AND, why did LePage propose to reduce these same numbers? That makes no sense.
YOu haven’t been paying attention to the hospital crisis that nearly closed about a half dozen hospitals and severely curtailed services at others…all due to the non-payment and slow payment of their bills…..and then we have the infamous billing computer fiasco and thye $25m spent to get it to work…had to fire the Canadian company who screwed it up. Then you have overpayments and the outrage in Belfast when the schools–yup, schools are big Mainecare users now; were over paid and allowed to keep the money to meet unauthorized operating expenses….all while the local hospital was at the local bank’s door begging for a loan to keep the doors open.
The Village Soup wrote up this Baldacci atrocity.
LePage is a thousand times better than having the Baldacci’crats running DHHS.
The only comment I have is that the Mainecare billing fiasco cost the taxpayers $80 million in direct costs and who knows how much in indirect costs. All for nothing as it NEVER worked and we had to hire a second company to actually design one that worked. All brought to you by our dedicated, hard working public servants.
If you don’t think it is the case then you just haven’t been paying attention. Some of these unpaid hospital bills are more than 5 years old. Here’s just one example of the destruction that Baldacci and company wrought. 35 people laid off because Baldacci and company wouldn’t pay the bills. Don’t those people count in your world rusjan?
http://bangor-launch.newspackstaging.com/2010/09/22/business/central-maine-healthcare-laying-off-35-employees/
“President and CEO Peter Chalke says the biggest problem is the millions
of unpaid state reimbursements for services provided under MaineCare,
the Medicaid program for low-income and disabled residents.”
Here’s one that explains how Lepage’s budget actually pays the bills for a change.
http://bangor-launch.newspackstaging.com/2011/01/12/health/with-supplemental-budget-lepage-seeks-to-pay-hospital-mainecare-dept/
“Through a state appropriation of nearly $70 million, Maine will be able
to access enough federal matching money to reduce a nearly $400 million
debt owed to hospitals for Medicaid services by $248 million.”
Please try to keep up. But I doubt you’ll even reply to this.
A fav. trick under the Baldacci regime was paying forward, i.e. dipping into next year’s budget allocation. Some one should put out a WEASEL FINANCE manual.
Well said! This is all a political ploy by the GOP.
1. Kick people off of public assistance, looks good to republicans, more votes.
2. People are desperate and go to hospital emergency rooms, inefficient and more expensive.
3. Cost’s get passed along to insurance companies.
4. Premiums go up to cover cost’s.
5. The GOP complains that “ObamaCare” isn’t working and use the increased premiums to prove this point.
6. More votes for republicans who said they knew all along that Obama’s healthcare initiative won’t work.
This is a self fulfilling prophecy strategy driven by a GOP that doesn’t really give a hang about Americans who aren’t in the top 1%.
Moronic ranting doesn’t help.
Despite the coverage of Mainecare; ER admissions skyrocketed….were you an intelligent, educated watch dog you’d have read the Muskie report on the Emergency room problem.
Here’s part of the summary:
“The statewide analysis focused on identifying high volume diagnoses and potentially preventable emergency department visits both statewide and for specific patient cohorts identified by age and payer source (insurance coverage). These analyses were based on 2006 hospital discharge data.
Key findings from this analysis include:
• Among infants under age one, top volume diagnoses do not vary among privately insured, MaineCare, and uninsured children and include, otitis media, upper respiratory infection, fever, and unspecified viral infection.
• Infants covered by MaineCare and uninsured infants made frequent visits for diagnoses
including diaper rash, teething problems, and “fussy infant.” These diagnoses were far less
frequently seen among privately insured infants.
• The top diagnostic reason for an emergency department visit among both MaineCare and
uninsured young adults aged 15 through 24 and adults aged 25 through 44 was dental disease.
• Fourteen diagnoses, all conditions that are frequently seen and treated in office and clinic settings, account for between a fifth and a quarter of total emergency department visits, depending on the health service area of the state. Most of these visits are preventable if care can be provided in an alternative setting.”
…
MaineCare primary care case management program: the high rate of ED use by MaineCareenrollees indicate that the PCCM program is not meeting the goals of providing caremanagement for some individuals in the program.’http://muskie.usm.maine.edu/Publications/PHHP/Maine-Emergency-Department-Use.pdf
Moronic ranting doesn’t help.
I think Organ missed the point.
LaSmoke&Mirrors should put the entire supplemental budget on the table so the Legislature knows what they have to work with. Doling it out piece by piece makes no sense.
Gov. LePage needs to provide a solid SAFETY NET for people whose coverage is being let go. How do you teach people to feed themselves when you’ve provided meals for them for so long? Breaking dependencies whether drugs or subsidized health care is difficult; but unless you want to start taxing ‘rich’ non profits like environmental groups and private colleges like Colby, then you have to make the cuts.
Whining and calling the Governor moronic names isn’t constructive—-but it does show how much we need mental health services!
Low paying jobs provide social structure, a workplace, some benefits, stability, job experience, job skills, and confidence….you don’t get any of this staying home and watching Oprah.
People on part-time jobs had to apply for Mainecare. There are more part-time jobs in Maine. The deductible is high for working people with insurance. The Insurance co’s have raised premiums Just because they could. If someone needs dental work, some put it ona credit card.
The amount of pay is different than the other benefits of working and there are plenty of Mainers working more than 2 jobs to keep up.
“We do see this as a removal of people from health care,” Rotundo said. “We feel there are ways you can reform MaineCare and reduce costs without taking services away. That’s what we’ve focused on and will continue to focus on.” So Rep. Rotundo…why haven’t you ALREADY done this long ago?