AUGUSTA — With June 30 behind us, Maine finished the state fiscal year without a Medicaid shortfall. This is the kind of story that news outlets typically report in the negative but overlook in the positive. Nonetheless, it is an important one and very good news for our state.

Medicaid is the federal-state health care entitlement program that Congress established in 1965 to support low-income and disabled beneficiaries. States administer the program directly and pay a formula-determined percentage – about 38 percent for Maine – for each Medicaid- eligible claim. The federal government pays the balance.

MaineCare, Maine’s Medicaid program, accounts for about 24 percent of state General Fund spending. Accordingly, unforeseen MaineCare cost overruns have the potential to derail otherwise balanced budgets.

Even casual observers of Maine politics will recall past news stories of large Medicaid “structural gaps” that threatened to undermine our state’s fiscal stability. In those years, Maine faced the unattractive alternatives of deferring Medicaid provider payments, reducing support for other government functions or raising taxes to meet funding demands.

Indeed, previous administrations employed each of those unfortunate remedies. The $490 million debt owed to Maine hospitals, which Gov. LePage repaid in his first term, was the sum of unpaid Medicaid bills resulting from MaineCare shortfalls.

Today, the dynamic is different for several key reasons.

• First, under Commissioner Mary Mayhew’s leadership, the Department of Health and Human Services implemented a comprehensive Medicaid expenditure forecast. Using triple-exponential smoothing, the MaineCare Forecast considers past data, trend and seasonality to predict program expenditures in our state. Twice each year, the MaineCare Forecast Team runs our review, during which finance and policy experts from across the department vet the algorithmic model’s results.

To date, the forecast has predicted Medicaid expenditures within 2 percent of annual outlays for this $2.6 billion program. Forecasting accurate outlooks for MaineCare funding needs means that the governor, department officials and other policymakers have the information they need to craft future spending plans, and that late-breaking Medicaid shortfalls will not sink otherwise balanced state budgets.

• Second, the department has right-sized MaineCare. At its peak enrollment in 2011, more than 354,000 Mainers – 27 percent of our state’s population – received Medicaid benefits. Today, that figure is about 282,000, or 21 percent of our population.

This is in line with the national average; it is more sustainable under our current budget structure; and it is still far more than the 190,110 Mainers whom Medicaid covered in 2002, when our population was the same 1.3 million it is today. Currently, the only Mainers who are not eligible for Medicaid or subsidized health insurance are able-bodied, childless adults earning less than 100 percent of the federal poverty level ($11,770 in 2015).

• Third, the LePage administration successfully opposed Medicaid expansion. Whereas expansion backers spoke of the economic windfall that increasing Medicaid rolls would have generated for Maine, the fact is that it would have cost our state hundreds of millions of dollars for marginal coverage gains.

During the first five years of expansion, our analysis demonstrated that Maine would have faced more than $220 million in additional General Fund spending on Medicaid. In the out years, as federal support for the program declined, that figure would have climbed significantly. The Associated Press’ recent report on Medicaid expansion (“Surging Medicaid enrollment worries states,” July 20) further validated those concerns.

The LePage administration has stabilized Medicaid spending. After causing years of fiscal uncertainty, the program is finally under control. That does not mean, however, that Maine-Care’s current funding level is advisable. One in every four General Fund dollars – derived from taxes and fees that Mainers pay to state government – supports Medicaid. Maine still spends about one-third more of its General Fund budget on Medicaid than the national average.

If our Medicaid spending matched the national average of 18 percent of General Fund outlays, Maine would have saved $190 million in FY 2015. That amount could have covered the entire General Fund budgets of the departments of Corrections, Economic and Community Development, Environmental Protection, Labor and Marine Resources combined. Or it could have funded an income tax cut of nearly 14 percent.

The department is pleased to report MaineCare’s more sustainable financial footing. We will, however, maintain our efforts to reform Maine’s Medicaid commitment, ensuring that we spend tax dollars efficiently and effectively and focus the program’s resources on our neediest and most vulnerable.