Veto vowed if hospital debt repayment is linked to Medicaid expansion

By Christopher Cousins, BDN Staff
Posted May 22, 2013, at 12:23 p.m.

AUGUSTA, Maine — Gov. Paul LePage’s administration said Wednesday that his veto pen is at the ready in anticipation of final passage of a controversial and long-debated bill that links Democrats’ plan to expand Medicaid eligibility with his proposal to repay Maine hospitals millions in past debt.

That means hours of debate and maneuvering Tuesday were far from the last chapter in what has become the biggest source of partisan discord in this legislative session. A Democratic spokeswoman said she expected the bill to be enacted by the House and Senate and sent to LePage’s desk by Thursday afternoon.

The LePage administration said Wednesday that the governor almost certainly will veto the bill.

Meanwhile, House Minority Leader Kenneth Fredette, R-Newport, is attempting to do what Republicans in the House and Senate failed to accomplish Tuesday: set up a study commission around the issue of expanding Medicaid. Fredette will attempt to convince legislative leadership to accept his after-deadline bill during a Legislative Council meeting on Thursday.

“If Democrats are truly interested in Medicaid expansion, they ought to support this bill,” said Fredette. “There likely will be a veto and the veto will be sustained. I don’t see how Democrats can’t support this.”

House Majority Leader Seth Berry, D-Bowdoinham, said none of that comes as a surprise to Democrats who contend that the Medicaid expansion is crucial enough for Maine’s economy and health care system that some Republicans should capitulate against the inevitable LePage veto. In fact, Berry said he hopes the governor himself will have a change of heart.

“The governor’s vetoes have been very unpredictable,” Berry said Wednesday morning. “We hope the governor will choose to do the right thing but if he doesn’t we’ll move forward. The governor needs to take ‘yes’ for an answer. … There are highly conservative, tea-party governors all over the country who have accepted these funds.”

Under the federal health care reform law, the federal government covers 100 percent of costs for newly eligible Medicaid recipients for three years. That 100 percent rate gradually drops to 90 percent by 2020, when the state would make up the rest. Proponents of the expansion say it would cover almost 70,000 Mainers.

In Maine, about 50,000 adults without children would gain Medicaid coverage if the state opts to expand, according to the Legislature’s nonpartisan Office of Fiscal and Program Review. If the state chooses not to expand, about 25,000 childless adults and parents would lose their Medicaid coverage on Jan. 1, 2014.

Berry said there is “zero chance” that Maine can negotiate a more favorable deal with the federal government on Medicaid expansion, despite that contention being at the core of Republicans’ arguments in favor of slowing down the process.

LePage spokeswoman Adrienne Bennett reiterated what LePage has said several times: that he will veto the bill if it ties paying back hospitals with expanding Medicaid.

“The governor is firmly on the record about that,” Bennett said Wednesday morning.

If Democrats vote together, overriding a veto would require a total of 12 independent and Republican votes in the House and four in the Senate. In numerous procedural votes on the bill in recent days, no Republicans have defected, though one Democrat did late Tuesday night and again Wednesday morning when the House voted on the bill.

First-term Rep. Stanley Short, D-Pittsfield, said Wednesday morning that he supports all three elements of LD 1546 — repaying hospitals, renegotiating the state’s liquor contract and expanding Medicaid — but was troubled that his party linked the issues.

“We’ve known for a long time what was going to happen if we linked these issues: it will be vetoed by the governor,” said Short. “You can’t sit down at a table and negotiate a contract if neither side is willing to make a move. Someone has to take the first step.”

Short said another reason for his vote with Republicans is that he is hopeful LePage will follow through on his commitment to release millions of dollars in voter-approved bonds if the Legislature repays hospitals. Short said he had notified Democrats before Tuesday night’s vote that he would break from their ranks.

Berry said he respected Short’s vote.

“Rep. Short made his own choice,” said Berry. “I respect that he and many Republicans seem to agree that all three parts of this bill are good for Maine.”

Meanwhile, as the House took its final 87-56 vote to enact the bill Wednesday morning, LePage kept the pressure on Democrats in a memo to Senate President Justin Alfond and House Speaker Mark Eves. The memo, which was given to the BDN by LePage’s office, was dated May 20, though Bennett said Eves and Alfond received it Wednesday. The memo was attached to two constituent letters LePage has received from Mainers, one from a conservative point of view when it comes to welfare spending and the other from a liberal.

“These two letters demonstrate the vast ideological differences between the Democratic philosophy toward welfare and the Republican approach to managing our welfare system,” wrote LePage. “The abject partisanship that has gripped the Maine State Legislature cannot be healthy for future generations. As we debate over each other’s approach, the state’s safety net for our most vulnerable rapidly erodes. … Both houses continue to ignore our most vulnerable population while offering free services to able-bodied adults.”

Jodi Quintero, spokeswoman for Eves, called LePage’s memo “blatant spin” that ignores many Mainers who desperately need health care coverage that the Medicaid expansion would provide.

http://bangordailynews.com/2013/05/22/news/augusta/lepage-ill-veto-hospital-debt-repayment-as-long-as-its-linked-to-medicaid-expansion/ printed on September 21, 2014