The Legislature’s Health and Human Services Committee last week postponed a vote on a contentious Medicaid expansion bill. It’s not clear when the committee will reschedule the vote, but the delay shouldn’t be a surprise.
Democrats have made expanding the publicly funded health insurance program, which the state calls MaineCare, a legislative priority since winning the majority in 2013. However, with the exception of a few Republicans and traditionally aligned interest groups, Democrats’ quest to expand Medicaid through the federal health care law has been a one-sided effort.
That seems to be changing.
There’s some speculation – and that’s all it is – that more Republican lawmakers are supportive of a bipartisan compromise plan that could solidify a veto-proof majority. Also, other interest groups, including the Maine State Chamber of Commerce, are involved in the discussion. If the Chamber can support an expansion bill, that could help Democrats pull in more Republicans.
There are signals that the broadening coalition is gathering some momentum. Gov. Paul LePage said recently that he expects Medicaid expansion will pass the Legislature. Nonetheless, there will still be a lot of pressure on Republicans to reject expansion, just as there was last year. Even if Democrats can bring along enough Republicans for the early votes in the House and Senate, holding them will be difficult.
That’s why you’re not hearing many actual names of Republican supporters. The longer they’re out there as “yes” expansion votes, the longer they’ll be lobbied by ardent opponents to reject it. It’s not an easy thing to support something most of your party opposes.
Also, the conventional wisdom has been that swing-district Republicans are the likely “yes” votes. But the swing-district theory doesn’t tell the whole story. There are rural Republicans in solidly conservative districts who may be feeling pressure from their constituents – or the local hospital – to back expansion.
The Maine Hospital Association will play a key role. Hospitals and the MHA seem to be more vocal about supporting expansion this year than they were last year.
That’s important because hospitals have a lot of influence in the State House, and in legislatures across the country. In some states, hospital support has tipped the balance in several expansion debates. That’s because hospitals are major employers and they have deep roots in their respective communities.
That influence is why LePage’s bill to repay Maine’s hospitals $183 million in backlogged Medicaid payments was so successful and politically effective last year.
It could be that Republicans with hospitals in or near their districts will feel the same pressure to vote for Medicaid expansion that Democrats felt to approve the debt payback revenue bond last year.
The hospitals have a financial stake in Medicaid expansion, but so do businesses.
Last week the AARP, an expansion supporter, circulated a report by the Jackson Hewitt Tax Service that said states that don’t expand Medicaid for adults could leave large employers exposed to so-called “shared responsibility” tax penalties in the Affordable Care Act. Under the law, employers that provide health insurance and have 50 or more full-time employees must pay up to $3,000 in tax penalties for each employee who applies for insurance assistance. According to the study, employers in the 25 states that don’t expand Medicaid will pay between $1.03 billion and $1.55 billion in penalties each year. The penalty estimate for large Maine employers is between $3 million and $4 million.
With that scenario looming, it’s no wonder that the Maine State Chamber of Commerce, which represents large and small businesses, is interested in a Medicaid expansion compromise.
NEW LIFE FOR CONSERVATIVE FORUM
As Maine Goes, the conservative Web forum that shuttered last year after a 15-year run, will relaunch this week.
Lance Dutson, a Maine-based political consultant and Web developer, has purchased the site from Scott Fish, who launched AMG in 1998 as an email newsletter. Over time the site grew into the go-to place for conservative political chatter, with many of its users posting anonymously.
Dutson, who helped Fish build the site’s back-end when it migrated from an email newsletter to a Web forum, said the old AMG will be integrated into a new one. For commenters on the old AMG, that means their old logins will still work and there will be an archive of all the old posts. There will be some small changes, Dutson said, with more aggregating of headlines on the home page.
Dutson said the biggest change will be in registering to comment. In the past, AMG commenters were screened. Now the site will allow people to comment through a registration form. Dutson, who will be the site’s editor, said he hoped that would encourage more participation and a broader debate.
“A robust political debate is the cornerstone to a free society,” Dutson said. “As Maine Goes has provided a platform for that debate for almost two decades, and I’m happy we were able to find a way to continue it. In the coming months, we’ll be working hard to find new and better ways to extend that opportunity for debate to a more diverse audience, and to provide a one-stop-shop for political conversation in Maine.”
Dutson, who launched one of Maine’s first political blogs in 2006, the Maine Web Report, will have a decent foundation from which to build. He said the site had nearly 2,000 registered users and more than 300,000 unique visitors per year.
MITCHELL TO ADDRESS LEGISLATURE
Former U.S. Sen. George J. Mitchell will address a joint session of the Legislature on Tuesday.
Mitchell’s speech is on the same day that his portrait will be displayed in the Hall of Flags. He’s expected to discuss his work with the Mitchell Institute, the only statewide scholarship, research and program organization in Maine. Mitchell created the program to increase the likelihood that young people in Maine will pursue and achieve a college degree.
SMALLER BUDGET HOLE
Health and Human Services Commissioner Mary Mayhew told the Legislature’s budget-writing committee Friday that the department’s shortfall is $30 million less than it had originally projected.
The department said last week that there was a $108 million shortfall, all driven by Medicaid overruns.
That announcement preceded a public hearing on expanding Medicaid, the public health insurance program for the poor.
Mayhew told the committee that her department re-crunched the numbers to uncover a much smaller overrun.
DIAMOND BACK IN
Former Democratic state Sen. Bill Diamond of Windham recently announced that he’ll try to win back his old seat in the Legislature.
Diamond, a former Maine secretary of state, served in the state Senate between 2004 and 2012. He was termed out in 2012 and prohibited from seeking a fifth consecutive term in 2013.
Diamond’s old seat will have a new number because of the redistricting plan adopted by the Legislature in 2013 It was District 12. It will be District 26, but it will cover the same territory: Windham, Raymond, Casco, Baldwin and Standish.
The seat is currently held by Republican Sen. Gary Plummer, who could run again but hasn’t announced or filed nomination papers with the state Commission on Governmental Ethics & Election Practices.
Steve Mistler can be contacted at 791-6345 or at: