Democrats oppose LePage budget cuts to prescription drug aid, hospital payments

By Matthew Stone, BDN Staff
Posted April 22, 2013, at 5:34 p.m.

AUGUSTA, Maine — Democrats on the Legislature’s Health and Human Services Committee have joined their colleagues on other committees in opposing a number of contentious portions of Gov. Paul LePage’s two-year budget proposal.

In a series of largely party-line votes, Democrats on the panel have opposed millions of dollars in cuts the LePage administration has proposed that would scale back prescription drug assistance for seniors, hospital Medicaid reimbursements, and general assistance payments to towns and cities. The administration has proposed the cuts in an effort to rein in Department of Health and Human Services spending and balance the budget.

The committee votes are part of a set of recommendations the Health and Human Services Committee made to the budget-writing Appropriations Committee on Monday. The Appropriations Committee is now charged with crafting a final budget for the two-year cycle that begins July 1.

Many of the cuts Democrats opposed in the Health and Human Services budget were similar to reductions the LePage administration proposed as part of a budget-balancing supplemental budget package passed earlier this year. Democrats in the Legislature removed many of those cuts from the final budget package.

Health and Human Services Committee members voted 7-5 against eliminating the state’s “Drugs for the Elderly” program, which aids some low-income seniors. The elimination would have cut $6.1 million from the budget over the next two years. Republicans, in the minority on the committee, proposed restricting eligibility for drug assistance to those who earn 100 percent of the federal poverty level or less — $15,510 for a two-person household — down from the current 185 percent eligibility level.

Democrats also opposed scaling back another drug assistance program for seniors, the Medicare Savings Program, which is available to seniors who receive Medicare but also qualify for some Medicaid benefits. The opposition to scaling back the program means budget writers will have to find an alternative means for filling a $16 million budget hole.

Democratic members of the committee said Monday they opposed the cuts in order to preserve needed services while Republicans said they supported some reductions as a way to meet savings targets.

On general assistance, Democrats opposed a measure that would cut state reimbursements to municipalities to 50 percent of costs from the current two-thirds level. General assistance is an aid program for low-income people that’s administered by local governments.

The LePage administration has also proposed making those who are no longer eligible for the Temporary Assistance for Needy Families program ineligible for general assistance. The Legislature two years ago imposed a five-year limit on TANF benefits, and many whose benefits have expired have turned to general assistance for help. Democrats on the Health and Human Services panel opposed that change, too.

And the administration proposed lowering the Medicaid reimbursement rate 16 of the state’s rural hospitals receive to 101 percent of costs, down from the current 109 percent. The move would have cut $4.9 million from the budget and deprived the hospitals of another $7.9 million in federal matching funds.

Democrats opposed the rate cut while Republicans on the Health and Human Services Committee proposed cutting it to 105 percent of costs instead of 101 percent. The 16 hospitals are known as Critical Access Hospitals because they provide 24-hour emergency care in rural areas.

The budget recommendations are now in the hands of the Appropriations Committee, which is charged with proposing a balanced budget package to the full Legislature. That budget will have to pass with two-thirds support from both chambers in order to take effect when the new fiscal year begins July 1.

While Democrats and Republicans split on some of the proposed cuts, members of the two parties both opposed a proposal in the LePage budget that would have eliminated reimbursement to nursing homes and other Medicaid-funded facilities for so-called “bed holds.” That funding allows facilities to reserve beds for patients when they’re outside the facility to receive hospital care or other treatment.

The Health and Human Services Committee delayed final action on that part of the budget, but plans to consider a bill on Wednesday, LD 1364, that reduces the number of bed hold days but leaves some funding in place.

The committee also voted in favor of some spending it rejected as part of the supplemental budget to upgrade the state’s Medicaid billing system to comply with federal requirements. Under LePage’s budget, the state would spend $1.25 million on the upgrade and receive $11.65 million from the federal government.

The budget proposal sets aside $9 million, which members of both parties agreed to, so the state can repay the federal government for Medicaid billing errors between 2005 and 2009.

http://bangordailynews.com/2013/04/22/health/democrats-oppose-lepage-budget-cuts-to-prescription-drug-aid-hospital-payments/ printed on December 18, 2014