BANGOR, Maine — Former Maine Health and Human Services Commissioner Mary Mayhew was appointed to lead the federal Medicaid program on Monday, marking the biggest move from the administration of Gov. Paul LePage to that of President Donald Trump.
No member of the LePage administration except for the governor himself has been a more polarizing figure than Mayhew, whose arch-conservative six-year tenure in the often-embattled health department became a road map for Republicans after the inauguration of Trump in 2017.
She was the face of LePage’s crusade against Medicaid expansion under the Affordable Care Act, which was approved by voters in 2017 but has languished unimplemented in a court fight with a pending expansion plan and a request for new Medicaid work requirements sitting before the agency where Mayhew will be a key official.
Mayhew began her job as director of Medicaid and the Children’s Health Insurance Program on Monday, according to an email from Seema Verma, administrator of the Centers for Medicare and Medicaid Services. Mayhew didn’t respond to a call seeking comment.
During her unsuccessful 2018 run for governor, Mayhew told the Bangor Daily News that she had “preliminary conversations” with federal officials interested in hiring her to administer the food stamp program under Trump, but they never progressed because she wanted to run for governor.
The Maine Department of Health and Human Services consumes about a third of state spending. By the time the Mayhew took control of it in 2011, it was infamous for shortfalls that ended during her tenure. But many have questioned the human impact of those changes.
Between 2011 and 2015, Maine culled the Medicaid rolls by 67,000 as the share of Mainers in poverty increased during that period. Enrollment in the Temporary Assistance for Needy Families program went from 25,000 children in 2011 to just more than 7,000 last month after the state established a 60-month lifetime limit with some exceptions.
She left the commissioner’s office in May 2017. After that, she traveled the country pushing conservative welfare policies for the Opportunity Solutions Network. Earlier this year, Trump touted contested links between food stamps and higher incomes identified by Mayhew here.
Mayhew, a Pittsfield native, began her career as a Democrat in the 1980s. At age 25, she managed the 1990 campaign of Democrat Patrick McGowan, who nearly knocked off U.S. Rep. Olympia Snowe, a Republican from Maine’s 2nd District. After that, she was a longtime lobbyist for the Maine Hospital Association and took a commissioner’s job that few wanted in 2011.
The technocratic Mayhew also had a bug for electoral politics. After being rumored as a candidate to succeed LePage for years, she declared for the Republican gubernatorial primary within two weeks of leaving the commissioner’s job. She finished in third place behind businessman Shawn Moody, who received support from many of LePage’s key allies.
Maine’s court fight between advocates and the LePage administration over Medicaid expansion is expected to stretch deep into the fall. While Maine’s high court directed the state to file a plan for expansion with the federal government, it’s unclear when it will be approved with legal questions about state funding left unanswered.
The Trump administration also allowed four states to extend work requirements to most regular Medicaid recipients, according to the Kaiser Family Foundation. Maine is one of seven states with a waiver to do that pending before the federal government.
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Correction: An earlier version of this story incorrectly stated that Medicaid expansion was approved by Maine voters in 2016. It was approved in 2017.