AUGUSTA, Maine — Republican Gov. Paul LePage on Thursday invited a select group of state lawmakers to an “informational session” held during a luncheon at the Blaine House, the governor’s official residence.
Those asked to attend included a number of rural Republican state representatives who have either said they would support a Medicaid expansion or who have supported the expansion in the past. Some are lawmakers who have said they would support an expansion if Democrats would accept other welfare reforms being proposed by LePage and other Republicans.
The meeting was set for about noon and appeared to start sometime after the Maine House of Representatives adjourned for the day Thursday.
One lawmaker who attended and asked not to be identified said they expected LePage to try to convince them to oppose a Medicaid expansion in Maine.
The Legislature is contemplating a bill that would do that under provisions of the federal Patient Protection and Affordable Care Act. LePage has voiced his opposition to such an expansion and twice vetoed similar legislation in 2013.
Adrienne Bennett, LePage’s press secretary, would not confirm the meeting with lawmakers, saying only the governor has many meetings every day.
Earlier in the week, LePage met with a small group of State House reporters and voiced his opposition to a proposal to expand Medicaid coverage in Maine while introducing reforms to the system, including the use of a managed-care model to lower health care costs.
LePage told the Bangor Daily News on Monday that he previously supported managed care but had changed his mind because he believes it would diminish the quality of health care without reducing overall costs to the extent supporters of the model claim.
Under the managed-care scenario, a third-party vendor would manage the state’s Medicaid services based on a per-patient model. The vendor would be paid a set amount per person in the system, instead of being paid for each service or procedure offered to a Medicaid recipient. That gives the organization an incentive to reduce unnecessary treatments and procedures and to lower costs.
LePage said he favors an accountable-care model, which would put the responsibility for lowering cost and improving service on the practitioners and care providers rather than a third party.
Under that system, LePage said, a hospital or other provider is given a predetermined amount of money to service a certain Medicaid population. If the provider can save money over the previous year, they get to keep half of the difference.
LePage told the newspaper he’s seen the ACO model work in other states, and is working with Maine Health and Human Services Commissioner Mary Mayhew to find ways to incorporate the model in Maine.
LePage remains opposed to expanding Medicaid in Maine. His staff says based on the studies they have seen, an expansion would add 97,000 Mainers to the state’s rolls. And while the federal government would pick up 100 percent of the cost for the first three years of the expansion, in the long run the expansion would end up costing taxpayers more than $800 million over a 10-year period.