WASHINGTON — U.S. Rep. Chellie Pingree is urging the U.S. Department of Health and Human Services to block a plan by Gov. Paul LePage to save money by dropping an estimated 27,000 low-income Mainers from the state’s Medicaid rolls.

The Republican governor bristled at the request Tuesday, accusing Pingree, D-1st District, of “putting her ideological views ahead of the Maine people.”

Other members of Maine’s congressional delegation suggested that they should be working with – not against – the state to address the costly Medicaid issue.

“It is highly unusual for a member of the Maine delegation, regardless of political affiliation, to urge a federal agency to act completely contrary to a request from a Maine governor that has the support of the state Legislature,” said Kevin Kelley, spokesman for U.S. Sen. Susan Collins, R-Maine, in an email.

The Medicaid issue is the latest political, and potentially legal, skirmish over Maine’s implementation of the Affordable Care Act, President Obama’s health care reform law.

In a letter Monday to DHHS Secretary Kathleen Sebelius, Pingree asked the department to reaffirm rules in the health care law that prohibit states from making deep cuts in their Medicaid programs without receiving waivers.

The waiver has been an issue in Maine for months, since LePage and Republican lawmakers approved changes to the eligibility requirements for MaineCare – the state’s Medicaid program – as a way to balance the state budget. The changes upset many Democratic lawmakers.

Republicans voted to eliminate Medicaid coverage for senior citizens and people with disabilities in the Medicare Savings Program, 19- and 20-year-olds, and parents whose income is 100 percent to 133 percent of the federal poverty level.

Such cuts previously required “Maintenance of Effort” waivers from the federal government – something no state has received.

And federal officials made clear last winter that Maine’s request would face long odds because the program was being scaled back for budgetary reasons.

Now, the LePage administration is indicating it believes that last month’s Supreme Court ruling on the Affordable Care Act ruling nullifies the waiver requirement.

The DHHS has yet to advise states on whether waivers are still needed.

Pingree contends that the court ruling doesn’t touch on the waivers. She urged Sebelius to say so.

“As you continue to examine the potential implications of the Supreme Court’s decision, and develop guidance for states on the current and future implementation of the ACA, I strongly hope that you will reaffirm your commitment to the MOE requirement,” Pingree wrote. “It is clear to me that the Governor’s proposed elimination of Medicaid coverage would not only adversely affect the health and well-being of Maine residents and upset Maine’s local economies, it would also be in direct violation of the MOE requirement, even in the wake of the Supreme Court’s ruling.”

Pingree is married to financier S. Donald Sussman, a contributor to Democratic and charitable causes and the majority share owner of MaineToday Media, which owns the Portland Press Herald/Maine Sunday Telegram, the Kennebec Journal in Augusta, the Morning Sentinel in Waterville and other media outlets in Maine.

Responses to Pingree’s request ran the gamut.

In a written statement, LePage accused Pingree of supporting President Obama’s health care law at the expense of Mainers.

“Unlike Congress, Maine must balance its budget and all the Congresswoman has done is made it harder for our state to be fiscally responsible,” Le-Page said.

“She’s part of big bloated government that hiked the debt ceiling to $16.4 trillion and is now saying that Maine should be forced to increase the burden on the taxpayers she claims to represent.”

LePage’s spokeswoman, Adrienne Bennett, said the administration believes Maine does not need a waiver because the “maintenance of effort” waiver constitutes an expansion of Medicaid, under interpretations of the Supreme Court ruling by LePage and Maine Attorney General William Schneider.

Instead, the state will file an amendment to its Medicaid plan with the DHHS within several weeks.

That process is perceived as posing a lower threshold to federal approval.

“If the federal agency does not approve the application, the state may then seek further redress in the courts,” Schneider said in a prepared statement.

But state Rep. Sharon Treat, D-Hallowell, who co-chaired a recent state task force on health care reform, said the Supreme Court never addressed the waiver issue.

She accused LePage and Schneider of engaging in “legal gymnastics” in an effort to eliminate MaineCare coverage for thousands of vulnerable people.

“I think it is a good thing that the congresswoman has written the letter because, once again, this has to be made clear to our governor and attorney general,” Treat said.

Other members of Maine’s congressional delegation were not as laudatory of Pingree’s letter.

Maine’s two Republican senators, Collins and Olympia Snowe, appeared to disagree with their colleague’s approach. Snowe called MaineCare a vital source of health care coverage for thousands of Mainers.

“At the same time, Medicaid provisions in the health reform law disadvantage Maine compared to other states when we are grappling with extraordinarily difficult budget decisions resulting from the worst economy in generations,” Snowe said in a prepared statement. “The entire delegation should be working collaboratively with the governor and the state Legislature to ensure we achieve the twin goals of tackling our state’s budgetary challenges while maintaining access to care for the most vulnerable.”

U.S. Rep. Mike Michaud, D-2nd District, did not weigh in on the issue but said it is “critical that (the DHHS) release guidelines to resolve this uncertainty as soon as possible.”

 

Washington Bureau Chief Kevin Miller can be contacted at 317-6256 or at: kmiller@pressherald.com

 

State House Writer Steve Mistler can be contacted at 791-6345 or at: smistler@pressherald.com

 

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