AUGUSTA, Maine — Gov. Paul LePage’s administration is starting conversations with officials in the Obama administration about a potential expansion of Maine’s Medicaid program under the federal Affordable Care Act.
LePage spokeswoman Adrienne Bennett said Monday that members of LePage’s administration began internal discussions about the Medicaid expansion within “the last couple of weeks,” after announcements from a number of other Republican governors that they would accept funds from the federal government to expand their Medicaid programs. Conversations with the U.S. Department of Health and Human Services were to begin Monday, according to Bennett.
“We’ve seen the deals struck by other states — and that’s not to say that Medicaid expansion is the right thing to do,” Bennett said. “It’s just that the right thing to do right now is begin a dialogue with the federal government and find out where Maine’s at.”
The LePage administration has so far remained opposed to expanding the state’s Medicaid program, saying Maine already has a generous Medicaid program it can’t afford and the state can’t count on a promise from the federal government to stick to increased Medicaid funding rates.
“What we want to ensure is that we have a minimal, quality safety net for our most needy and one that is affordable for Maine people,” Bennett said.
Over the past few months, a growing number of Republican governors who, like LePage, staunchly opposed the Obama administration’s health care reform bill have said they would sign their states up for a Medicaid expansion, citing the potential for additional federal funds to provide more of their residents with health insurance.
Florida Gov. Rick Scott, whose state was a lead plaintiff last year in the case to overturn the Affordable Care Act, recently endorsed a three-year expansion of Medicaid in his state though a Florida Senate committee on Monday opposed the move, with the committee’s Republican chairman saying he hoped Florida would ultimately withdraw from the Medicaid system. Other Republican governors who have supported expanding Medicaid in their states include Chris Christie of New Jersey, Rick Snyder of Michigan and John Kasich of Ohio.
Arkansas Gov. Mike Beebe, a conservative Democrat, struck a deal with the Obama administration that will allow his state to use Medicaid expansion funds to expand private insurance available to low-income residents through his state’s health insurance exchange.
Bennett said the LePage administration doesn’t have its eye on a particular state model for expanding Medicaid. Maine is an outlier, she said, because it expanded Medicaid coverage early.
“Our governor is a businessman, and he’s looking for the best return on investment in this case,” she said. “We’ve got to have further conversations with the federal government about it. It’s a little too early to get into the depths of those conversations.”
While LePage has indicated he’s opposed to expanding Medicaid, Democrats in the Legislature recently have become more vocal about the issue. Democratic leaders Monday called for Maine to participate in the Medicaid expansion as part of a larger hospital debt repayment plan they laid out as an alternative to LePage’s. Rep. Linda Sanborn, D-Gorham, has proposed a bill that would sign Maine up for the Medicaid expansion.
Democratic leaders Monday said they were encouraged the LePage administration has started discussing a Medicaid expansion with federal officials.
“Democrats see this as a key priority and we are pleased to see Gov. LePage taking an interest,” House Speaker Mark Eves, D-North Berwick, said in a statement.
A recent Kaiser Family Foundation analysis projects that Maine would be one of 10 states to see the amount of state funds it spends on Medicaid actually drop over the next decade — by $570 million, or 3.8 percent — while the federal share of Medicaid expenses would rise by $3.1 billion, or 11.4 percent.
That’s because the federal government is promising to increase its share of costs for states like Maine that have already expanded Medicaid. Maine expanded its Medicaid program to parents and adults without children — two of the populations covered by the federal Medicaid expansion — in the late 1990s and early 2000s.
The Kaiser analysis projects Maine’s Medicaid rolls will grow by 55,000 people over the next decade if the state expands the insurance program. Even if Maine doesn’t expand, the analysis predicts 10,000 more people who may now be eligible but are unenrolled will join the rolls. Part of that could be the result of the Affordable Care Act’s individual mandate, which requires everyone obtain insurance coverage.
The Kaiser analysis also projects that Maine’s hospitals would see $348 million more in payments from Medicaid over the next decade if the state expands the program. They would also have to provide less care for which they aren’t paid, according to the analysis.
Correction: An earlier version of this report indicated the LePage administration’s conversations with federal officials began within the last couple of weeks. LePage spokeswoman Adrienne Bennett later clarified that internal discussions began two weeks ago and that conversations with federal officials began Monday.