AUGUSTA — Democrats’ plan to link Medicaid expansion to repayment of the state’s debt to its hospitals was officially killed Wednesday, when Senate Republicans voted to sustain Gov. Paul LePage’s veto of the plan.

The 20-15 vote on L.D. 1546 virtually ensures that hospital debt payment and Medicaid expansion will be considered separately, as Republicans including LePage have demanded.

While Democrats and independent Sen. Richard Woodbury of Yarmouth voted to override LePage’s veto, a two-thirds majority is needed for an override. Republicans hold 15 of the Senate’s 35 seats.

“Democrats will not (waver) in our fight to pay back our hospitals and extend health care coverage to thousands of Maine people,” said House Speaker Mark Eves, D-North Berwick, in a prepared statement. “We will not fold in our fight for the health care of Maine people. We will not fold in our fight to strengthen our hospitals.”

The bill would have extended Medicaid coverage to an estimated 60,000 Mainers while paying the hospitals $186 million with revenue from the state’s next wholesale liquor contract.

Hospital repayment is perhaps LePage’s primary policy goal of this legislative session. Democrats have expressed agreement with that goal but have made Medicaid expansion one of their biggest goals.

They point to a Kaiser Family Foundation estimate that Maine would save $690 million by participating in the federal expansion of Medicaid under the Affordable Care Act, and say it would be irresponsible to repay hospitals without containing health care costs.

LePage has said he will consider expanding Medicaid if the state gets the right deal. The federal government has offered to pay 100 percent of the cost of expansion from 2014 to 2016, and 90 percent in subsequent years. The governor has asked the Obama administration to fully fund the expansion for 10 years.

Eves has said that’s an unrealistic offer that shows LePage’s “insincerity” in negotiating expansion, which several other Republican governors have done.

Adrienne Bennett, LePage’s spokeswoman, said the governor’s position shows he is “serious about the long-term financial stability” of Maine, where cost overruns have long plagued MaineCare, the state’s Medicaid program.

She said the state has a “longer period of time” than the rest of this legislative session to negotiate a Medicaid expansion deal.

The Legislature is set to adjourn in June, and if Maine pays the hospital debt by October, it will avoid a $5 million penalty, the Maine Hospital Association has said.

Republicans have been wary of cost-savings estimates and the federal government’s ability to live up to its offer.

“There are two separate issues here: One is making sure we pay our bills, the other is a debate about Medicaid expansion,” said Senate Minority Leader Michael Thibodeau, R-Winterport. “Senate Republicans stand ready to debate each issue on its merits.”

In a brief question-and-answer session with reporters Wednesday, LePage expressed apparent suspicion about the Medicaid expansion process.

“Expanding Medicaid, that’s not being done locally,” he said. “That’s being done nationally. It’s being run by our congressional delegation. In fact, one of them owns one of the newspapers in this state.”

That was a reference to Democratic U.S. Rep. Chellie Pingree and MaineToday Media, which owns the Portland Press Herald, the Kennebec Journal and the Morning Sentinel. Pingree is married to S. Donald Sussman, the majority share owner of MaineToday Media.

Jodi Quintero, a spokeswoman for Eves, said that while hospital repayment and Medicaid expansion are top priorities for Democrats, they haven’t yet established a way to get both proposals through the Legislature.

She said a Medicaid expansion bill, sponsored by Rep. Linda Sanborn, D-Gorham, is still alive before the Legislature’s Health and Human Services Committee. Two bills dealing with hospital repayment from liquor proceeds are before the Veterans and Legal Affairs Committee. LePage reintroduced his own plan last week.

Quintero said Democrats could outline a plan as early as Thursday to get the repayment and expansion done.

But House Minority Leader Kenneth Fredette, R-Newport, said Republicans question Democrats’ sincerity in negotiations, considering the majority party’s push to link the issues.

“You don’t just get the chance to just hit the rewind button,” he said.

Michael Shepherd can be contacted at 370-7652 or at:

mshepherd@mainetoday.com

Twitter: @mikeshepherdme