Tuesday, May 21, 2013
Maine Gov. Paul LePage
The cuts to MaineCare, the state's version of Medicaid, are scheduled to take effect Oct. 1 and save about $20 million for the Department of Health and Human Services.
They would eliminate health care benefits for an estimated 24,000 low-income parents, nearly 7,000 19- and 20-year-olds and 1,800 Medicare recipients who receive additional benefits under MaineCare.
"I appreciate that your budget is predicated on the savings anticipated from ending the Medicaid coverage of the groups of individuals at issue in the proposed (plan), but your request raised issues that require careful consideration," wrote Marilyn Tavenner, acting commissioner of the Centers for Medicare and Medicaid Services, in a letter to LePage.
The LePage administration sent its plan to U.S. Health and Human Services Secretary Kathleen Sebelius on Aug. 1 and asked for a response by Sept. 1.
Tavenner wrote that federal regulations allow 90 days, which would give Maine its response at the end of October. "I want to assure you that we will review your plan amendment carefully and render a decision promptly," she wrote.
Adrienne Bennett, the governor's spokeswoman, did not respond to requests for comment Friday.
Rep. Patrick Flood, R-Winthrop, who co-chairs the Legislature's Appropriations Committee, said he hadn't seen the letter.
"We have a meeting next Friday; I'm sure that we'll want to add that topic to the agenda," Flood said. "I would like to see this matter concluded sooner than later, but it's one of the most complicated topics we deal with so it's not a great surprise."
Democrats, who have opposed the cuts, were relieved by the delay.
"We're pleased that (the Centers for Medicare and Medicaid Services) is resorting to due diligence," said Sen. Dawn Hill, D-York, a member of the Appropriations Committee. "If we don't have permission, we shouldn't be making these cuts."
The DHHS has been moving forward with plans to make the changes as of Oct. 1. It published legal ads in early August in the Portland Press Herald giving formal notice of the changes. The notice said that the department will hold a public hearing on the rule changes at 9 a.m. Sept. 4 at 19 Union St. in Augusta, and that written comments will be accepted through Sept. 14.
"If the department does not receive federal approval prior to October 1, 2012, the department will abandon this rulemaking and the commissioner will not adopt these rules," the notice said.
The cuts appear to require a waiver of Medicaid standards that the federal HHS agency has never granted to any state, but the LePage administration has said the U.S. Supreme Court's decision in June to uphold the Affordable Care Act gave states flexibility to make changes.
LePage has defended the cuts as necessary to restore fiscal solvency to the state DHHS. By saving about $20 million, the changes to MaineCare would help balance the state budget, as required by law.
Top Democrats have argued that the budget problems in the DHHS have been overblown by the administration to sell the structural changes to MaineCare that it wanted.
They have conceded that the Legislature did have to cut spending in this year's session, but said eliminating coverage for 19- and 20-year-olds and low-income parents was not the only option. They have pointed out that the state ended the 2011-12 fiscal year June 30 with a $20 million surplus.
If Maine does not get approval to make the cuts, it could sue the federal agency. And if it moves forward with its cuts without permission, the state could be sued.
Staff Writer Eric Russell can be contacted at 791-6344 or at: