December 11, 2018
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LePage can expect a lawsuit if he blocks Medicaid expansion

Robert F. Bukaty | AP
Robert F. Bukaty | AP
In this Tuesday, Nov. 7, 2017, file photo, supporters of Medicaid expansion celebrate their victory, in Portland, Maine.

Much has been written and said about last year’s referendum to expand Maine’s Medicaid program under the provisions of the Affordable Care Act and the funding battle that’s brewing this year in the Legislature.

But according to Assistant House Majority Leader Jared Golden, D-Lewiston, there will be no battle.

Golden says Democrats don’t intend to engage in a funding debate this year because the Legislature’s fiscal office has already determined there is enough funding in the Medicaid program to last through May of 2019.

“It’s important that every time the governor talks about ‘the Legislature hasn’t put forward any funding so I’m not going to do my job,’ that the people recognize he’s simply making excuses,” Golden said Wednesday.

LePage and some Republicans — including most of the party’s gubernatorial candidates — have made it clear that they want to find a way to block Medicaid expansion. LePage refused to send Department of Health and Human Services officials to discuss the issue with lawmakers in December and wrote in a letter that the Legislature would have to find funding without a tax increase or using money from the budget stabilization fund.

Meanwhile, according to the expansion law, the administration is directed to begin planning with the federal Center for Medicaid and Medicare Services now in preparation for submitting an expansion plan in the spring and bringing new enrollees into the program as of the beginning of July.

Golden said expansion proponents’ strategy is to watch for signs that the LePage administration is not moving forward with expansion and, if not, to sue him.

“The organizations that banded together to support Question 2 feel like they have a bullet-proof legal argument,” he said.

Robyn Merrill, executive director of Maine Equal Justice Partners, said her organization’s mission is to represent low-income Mainers who are unlawfully denied public benefits. She said she hopes the Medicaid expansion referendum doesn’t end up in court but that MEJP would represent individuals who are denied coverage if the plan isn’t implemented as scheduled.

“We have a legal team that is ready to do that if necessary,” Merrill said.

Last month, the Legislature’s budget committee met to discuss estimates of how much expansion will cost. That meeting ended without consensus and with the committee sending a list of questions to the Department of Health and Human Services, from which LePage barred officials from participating. Merrill said the Legislature and Office of Fiscal and Program review need to determine the closest possible cost estimate, even if a funding mechanism is left to decide in the future. Merrill said when savings resulting from expansion are considered — such as people leaving other state programs for Medicaid — the cost is lower than current OFPR estimates.

“People are going without health care that they need,” said Merrill. “We want the administration to act swiftly and respect the will of the voters. This is life and death for some people.”

Going to court could create a stalemate that would delay the expansion for months and possibly until after LePage leaves office in January 2019, but Golden balked at the word stalemate and said LePage’s funding demands are a “false battle” over funding that’s not needed this fiscal year or until near the end of the next.

Though the funding discussion may be delayed, it has to happen sometime. The Legislature’s fiscal office expects expansion of the program and giving taxpayer-funded health care to at least 70,000 more Mainers to cost some $55 million a year, though LePage has said there will be more enrollees than that at nearly double the cost.

Mike Tipping, a spokesman for the Maine People’s Alliance, who partnered with MEJP on the referendum, said after the referendum made expansion the law, there is no viable path to stopping it.

“It’s not a showdown. It’s not a fight anymore,” said Tipping. “It’s only a matter of time.”

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