AUGUSTA, Maine — A dispute over Medicaid cuts between Gov. Paul LePage and Maine Rep. Chellie Pingree escalated Wednesday, with LePage accusing Pingree of defying the will of Maine people and siding with Washington bureaucrats, and Pingree saying she won’t back down from trying to preserve health coverage for those slated to lose it.
In a strongly worded letter to the Democratic representative, LePage wrote that Pingree has “become part of the jet-setting Washington culture that keeps people dependent on government handouts.”
LePage’s letter was a response to a letter Pingree sent earlier this week to U.S. Health and Human Services Secretary Kathleen Sebelius in which she asked the secretary to block cuts to Maine’s Medicaid program that LePage and Republican lawmakers have been counting on to balance the state budget.
Pingree’s request to Sebelius said that, while the Supreme Court’s recent ruling on the Affordable Care Act found it was unconstitutional for the federal government to penalize states for not participating in an expansion of Medicaid programs, the ruling doesn’t invalidate a part of the health care law that bars states from scaling back existing Medicaid services.
Republican lawmakers in May passed a supplemental budget bill that does just that by tightening eligibility requirements for some Medicaid services and eliminating Medicaid coverage for 19- and 20-year-olds. Those Medicaid cuts were estimated to save about $10 million, according to the Maine Department of Health and Human Services, and were among a series of measures meant to plug an $83 million Health and Human Services budget gap.
The Department of Health and Human Services says the cuts are expected to affect coverage for 21,000 people.
The LePage administration had planned to seek a federal waiver that would allow the state to make those cuts, but the administration is reading last month’s Supreme Court ruling as a sign it can move ahead with scaling back the state’s existing Medicaid program.
Sebelius’ interpretation of the ruling, however, appears to line up with Pingree’s and put her at odds with LePage.
In a letter Sebelius sent to governors Tuesday night to explain some of the Obama administration’s next steps in implementing the Affordable Care Act, Sebelius said the court’s decision applies only to the Affordable Care Act’s Medicaid expansion and to no other Medicaid-related provision of the health care law.
“The Supreme Court held that, if a state chooses not to participate in this expansion of Medicaid eligibility for low-income adults, the state may not, as a consequence, lose federal funding for its existing Medicaid program,” Sebelius wrote. “The court’s decision did not affect other provisions of the law.”
In his letter to Pingree, LePage accuses the First District congresswoman of implying that the governor was unilaterally seeking the Medicaid cuts and mischaracterizing the cuts as “drastic.”
“While you might not like the welfare reforms made by the Maine Legislature, it is astounding that you would actively advocate for the Federal Government to overrule Maine’s decisions,” LePage wrote. “Your title says that you are a Representative from Maine, but apparently you prefer to represent the power of bureaucrats in Washington, D.C.”
In a statement issued Wednesday afternoon, Pingree said she didn’t intend to start “a personal dispute” with LePage, but said she wouldn’t “back down from speaking out” for the Maine residents slated to lose health coverage.
“The Maine people who stand to lose their health care are seniors, young people, people with disabilities and working families struggling to make ends meet,” she said. “The health care reform law was debated and passed by Congress, signed by the president and upheld by the Supreme Court. It’s time to stop fighting about the health care law and start following it.”
LePage had said in his letter that state’s Medicaid cuts were “a necessary correction” to the program’s size, since the level of Medicaid benefits Maine offers is above the national average.
“We either fix it now or it fails for everyone,” he wrote.
LePage on Wednesday also sent a letter to Sebelius telling the secretary that Pingree’s “position does not represent the state of Maine” and urging her “to put aside [Pingree’s] opinion piece and ensure that Maine’s upcoming submission receives a full, fair and equitable review, free of political interference.”
The LePage administration plans to move ahead with its Medicaid cuts, which are slated to take effect Oct. 1, by applying to the federal Centers for Medicare and Medicaid Services for an amendment to Maine’s Medicaid State Plan.
While the amendment would require federal approval, the amendment process is more routine than the process for obtaining a full-fledged federal waiver from the health care law’s requirements, said John Martins, a Maine Department of Health and Human Services spokesman.
Maine Attorney General William Schneider said Tuesday that Maine might “seek further redress in the courts” if the federal government doesn’t grant its amendment request.