AUGUSTA, Maine — A key committee of the Legislature tabled a bill Wednesday that would vastly expand the state’s Medicaid program, as Democratic lawmakers worked to build a bipartisan coalition to support the expansion.
The measure, LD 1578, is similar to two others vetoed by Republican Gov. Paul LePage in 2013. Further discussion was postponed by the Legislature’s Health and Human Services Committee after new information from the federal Centers for Medicare and Medicaid Services was presented to lawmakers.
That information included confirmation from the federal government that it would cover 100 percent of the costs of newly eligible childless adults during the first three years of the expansion.
A letter from the federal government also confirmed Maine and other states that elect to expand their Medicaid programs under the federal Patient Protection and Affordable Care Act could withdraw from the program in the future if they found it too costly or if state policymakers determined the expansion was not in a state’s best interest.
Key to the bill now before the committee is a provision that sunsets the expansion in three years if a future Legislature chooses not to continue the program in its entirety.
Lawmakers also are working behind the scenes to craft amendments to the bill that would entice more Republicans to join Democrats in supporting the expansion.
Several House Republicans have said they could support an expansion if other changes were made in the way the state manages MaineCare, its Medicaid program.
Conservatives have said the key to accepting an expansion would be reforms, including some proposed by LePage, for Maine’s other welfare programs.
On Wednesday, Democratic leaders said a bipartisan coalition of lawmakers had been formed and they were working earnestly to deliver votes on expansion that would go to LePage’s desk with a veto-proof margin.
“The conversations are very energized and fluid at this point, but we really feel good about the good-faith effort that is happening between Democrats and Republicans around this issue,” said House Speaker Mark Eves, D-North Berwick.
Six Republicans in the House previously supported the expansion or voted to overturn LePage’s vetoes. Three Senate Republicans and one independent have supported expansion in the past.
The 35-seat Senate needs 24 votes to be veto-proof. The House of Representatives, with 151 voting members, needs 101 votes to reach the veto-proof threshold. To override a veto, the respective bodies need two-thirds of the members present.
“We know we have six Republicans that voted for it last time in the House on the (veto) override,” Eves said. “And there’s a number of Republicans in addition to that, that are looking at expansion and the benefits of it and any further compromise we might need to do to get them on board.”
Counting all House Democrats, along with the four independent members, the House would need eight Republicans, including the six who voted with them last time, to join them for a veto-proof majority.
“We clearly want to have a veto-proof majority once it comes to the Senate,” said State Senate President Justin Alfond, D-Portland. He said at least three Republicans in the Senate were likely to support an expansion under the right conditions. With those three, 19 Democrats and one independent, Alfond has to muster just one more Republican vote.
Both Eves and Alfond said Wednesday they were not taking the vote of any lawmaker for granted, but they were optimistic they would gather enough votes to foil another LePage veto.
Eves said there were a lot of potential compromise ideas floating around the State House, but he wouldn’t be specific because, he said, he did not want to give additional “credence” to one idea over another.
He said the conversations about future expenses, once the state must pick up 10 percent of the expansion funding four years from now, were honest and candid.
“There’s just a lot of good, vibrant conversations going on right now,” Eves said.
Alfond said the committee had not set a firm timetable and intended to give the bill the time it needed in committee so it could come to the full Legislature with the maximum amount of support from both Republicans and Democrats.
Meanwhile, Peter Steele, a LePage spokesman, said the governor’s opposition to a Medicaid expansion remained firm.
“The governor’s position on the massive expansion of welfare has not changed,” Steele wrote in an email to the Sun Journal. “Nor would he support any so-called compromise that raises taxes on hardworking Maine families or promises fictitious savings at some unspecified point in the future or adds able-bodied people to Maine’s existing welfare programs before our elderly and disabled citizens on wait lists are provided with the services they need.”
New federal tax burden
Also surfacing Wednesday was a study by the private firm, Jackson Hewitt Tax Services, that suggests states that refuse to expand their Medicaid systems may be unknowingly placing a new federal tax burden on their largest employers.
Key findings in the report highlight the impact of not expanding Medicaid, and the report used Texas and Maine as examples.
“… the decision in Texas to forgo the Medicaid expansion may increase federal tax penalties on Texas employers by $266 million to $399 million each year,” according to the report. “Likewise, employers in Maine may pay $3 million to $4 million dollars each year in federal tax penalties if the state does not expand Medicaid for adults.”
The report warns that any study of the net costs of an expansion to a state should include the net costs to large employers.
That report followed information released earlier this month by the Rhode Island-based Alexander Group that Maine could face up to $807 million in new state costs over the next 10 years should it choose to expand Medicaid.
Republican hardliners remain intent on rejecting an expansion of Medicaid in Maine, citing the high costs to taxpayers over the long haul.
House Minority Leader Ken Fredette, R-Newport, said he was cautioning moderate Republicans that constitutionally they cannot bind the actions of a future Legislature.
Fredette has said that about half of those who would become eligible under an expansion would also qualify for federal subsidies to buy health insurance on the private market.
“It is incumbent upon Republican legislative leaders to continue the work of putting Maine’s fiscal house in order after decades of irresponsible liberal policies, which means Medicaid expansion cannot and should not pass the Legislature with Republican support,” Fredette wrote in a prepared statement.