December 19, 2018
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Maine legal battle keeping Medicaid expansion in limbo to stretch into October

Robert F. Bukaty | AP
Robert F. Bukaty | AP
Mainers for Health Care rally outside the State House prior to Gov. Paul LePage's State of the State address, Tuesday, Feb. 13, 2018, in Augusta, Maine.

PORTLAND, Maine — Advocates for Medicaid expansion withdrew a request in a Maine court on Friday to have a third party manage implementation of the voter-approved law given Gov. Paul LePage’s opposition to it, but their case will stretch far into fall.

Maine voters approved expanding Medicaid to 70,000 people under the federal Affordable Care Act last year, but the Republican governor hasn’t implemented it. A group representing Mainers who say they would be eligible for care under the long-gone July 2 deadline for coverage sued LePage over that delay in April.

Last month, the Maine Supreme Judicial Court ordered the state to submit an expansion plan to the federal government. While the Maine Department of Health and Human Services quickly filed one, the plan was accompanied by a LePage letter saying it should be rejected.

At the same time, the high court sent unanswered, core legal questions back to Maine Superior Court Justice Michaela Murphy, who held two days of hearings in Portland on Thursday and Friday with lawyers for Maine Equal Justice Partners, the progressive group leading the suit, and the state.

Little was decided by the end of those proceedings, but on Friday, expansion proponents withdrew a motion asking Murphy to hold the state in contempt of the high court’s order, which was originally filed because of LePage’s letter asking the federal government to reject the plan.

They were assuaged after the department filed a letter with the federal Centers for Medicare and Medicaid Services noting that the effective date of coverage under the law is being disputed in court — which could preserve coverage for thousands of people who have sought it since July.

Murphy will likely have to rule on that and the key legal question in the case — whether the LePage administration can implement a law without dedicated funding from the Legislature. The governor successfully vetoed a start-up funding plan from the Legislature earlier this year.

Advocates have argued that existing funds could be used to pay for expansion, while private lawyers for the LePage administration have said that a dedicated appropriation is required. Both sides looked to bolster those cases in questioning of witnesses this week.

But Murphy issued no decisions, and the sides agreed to submit legal briefs on core issues in the case by mid-October. The sides will likely present arguments to the lower-court judge before she her ruling, and any ruling is likely to go back to the high court later this year.

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