Maine Senate upholds LePage veto of bill linking Medicaid expansion to hospital repayment

Maine Governor Paul LePage speaks about his plan to repay money owed by the state to hospitals at a press conference in Portland on Jan. 15, 2013.
Maine Governor Paul LePage speaks about his plan to repay money owed by the state to hospitals at a press conference in Portland on Jan. 15, 2013. Buy Photo
Posted May 29, 2013, at 12:44 p.m.
Last modified May 29, 2013, at 7:57 p.m.

AUGUSTA, Maine — Democrats’ first effort to link Medicaid expansion with a plan to repay Medicaid debt to Maine hospitals died officially on Wednesday when the Senate failed to override Gov. Paul LePage’s veto of a bill that would do so.

Mirroring all previous votes on a bill that linked the two, the Senate voted 20-15 to override the veto, falling short of the two-thirds needed for an override. Democrats and independent Richard Woodbury voted for the override. All Republicans voted to sustain LePage’s veto. Only Senate Democratic Leader Seth Goodall of Richmond and Senate Republican Leader Michael Thibodeau of Winterport spoke before Wednesday’s veto vote. They reiterated past party arguments.

The provisions within LD 1546, “An Act to Strengthen Maine’s Hospitals, Increase Access to Health Care and Provide for a New Spirits Contract,” have been under debate since January but weren’t included in a single bill until earlier this month. Democrats on the Legislature’s Health and Human Services Committee attached an expansion of Medicaid under the federal Affordable Care Act to Gov. Paul LePage’s plan to repay Medicaid debt to hospitals with the proceeds of a renegotiated state liquor contract.

That angered LePage, who last week held a press conference and made a show of vetoing the bill before it had even arrived on his desk and minutes before Democrats held their own press conference on the issue. The governor said he would introduce a new bill that proposes repaying the hospitals without linking to Medicaid expansion.

As an incentive to lawmakers, LePage wrote in his veto letter to the Legislature that he has directed State Treasurer Neria Douglass to ready $105 million in voter-approved bonds to be released if lawmakers pass his hospital debt repayment plan, which is a promise the governor has voiced since January.

“The sad part of this veto is the simple fact that all of us have agreed paying our bills is the fiscally responsible thing to do,” LePage’s veto letter reads. “Additionally, the bipartisan work of the committees has recognized my original plan is the best way to do it.”

At issue is $484 million in state and federal funding that is owed to 39 Maine hospitals. Under LePage’s plan, the state’s $181 million would be covered by renegotiating a better deal for the state on the nearly 10-year-old state liquor contract and purchasing a revenue bond with the proceeds.

The arguments for and against the veto were brief Wednesday morning in the Senate and similar to the hours of testimony and legislative debate that have already centered around the question.

“Make no mistake about it. If we vote today and do not override this veto, you’re voting against paying back the hospitals,” Goodall said. “You’re voting against providing health care to 70,000 Mainers. Our resolve if we are not successful here today in overriding this veto will not be slowed down in a fashion.”

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.

Neither Goodall nor Thibodeau managed to sway a single senator.

“There are two separate issues here,” said Thibodeau. “One is making sure we pay our bills. The other is a debate about Medicaid expansion. … The timing on Medicaid expansion has not come. Senate Republicans believe the administration needs an opportunity to negotiate with the federal government on this matter.”

Democrats in the Legislature appear poised to continue pushing for Medicaid expansion.

“Democrats will not waver in our fight to pay back our hospitals and extend health care coverage to thousands of Maine people,” House Speaker Mark Eves said in a statement released after the Senate’s veto vote. “I’ve said many times, that to do one without the other, would leave the job half done. We will not fold in our fight for the health care of Maine people. We will not fold in our fight to strengthen our hospitals.”

After Wednesday’s veto vote, the Senate Democrats issued a statement saying that the Legislature’s Health and Human Services Committee is likely to vote Thursday on LD 1066, a bill that specifically calls for the state to pursue Medicaid expansion. The committee tabled that bill after voting along party lines to link Medicaid expansion to LD 1456.

House Republican Leader Kenneth Fredette of Newport has introduced a bill that calls for a study of Medicaid expansion. House Republicans pointed to a New Hampshire Senate committee’s decision last week to recommend a similar study.

CORRECTION:

An earlier version of this story reported that Legislature’s Health and Human Services Committee is likely to vote Wednesday on LD 1066. They will likely vote Thursday.

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