Wednesday, April 23, 2014
By Michael Shepherd firstname.lastname@example.org
AUGUSTA — The Maine Hospital Association’s lobbyist said Monday he is “surprised and disappointed” with legislative Democrats’ proposal to expand Medicaid eligibility at the same time the Legislature repays hospital debt.
While hospitals support both the debt repayment and Medicaid expansion, differing time frames for legislative action means that linking the two issues could slow down the payment of $484 million owed to hospitals, Jeffrey Austin said Monday. If Maine pays the hospitals money owed for past care before October, the state will save $5 million.
“We feel we’ve met all of our obligations to be paid” the money owed for past care, Austin said. “Linking the two is unacceptable.”
Gov. Paul LePage also opposes the idea and blasted Democratic leaders in a statement Friday, a day after they told him of the plan. LePage's statement said the Democrats reneged on their commitment to pay back hospitals, while they said it's still a top priority.
However, Austin said he hadn’t heard of a proposal linking the two issues before Friday.
Adrienne Bennett, a LePage spokeswoman, said resolving the Medicaid issue will take longer than repaying the hospitals because the administration is looking for the best possible Medicaid-expansion deal from the federal government.
LePage issued another statement Monday calling upon legislators to give his original hospital payment proposal an up or down vote.
“Republicans and many good Democrats have been ready for months to pay the hospitals, and the Maine people know it is the right thing to do,” LePage said. “I’m calling on Democratic leadership to let legislators take a simple up-or-down vote on my plan.”
After initially presenting their own plan to pay back Maine’s $484 million in hospital debt, Democrats have recently warmed to a plan similar to LePage’s: issuing a revenue bond that would pay the $186 million state share of debt at once, unlocking federal money to pay the rest.
The borrowing would be paid back by liquor-contract revenue. Recently, the Legislature’s Veterans and Legal Affairs Committee has said it plans to draft a bill in that vein.
Meanwhile, the Legislature’s Health and Human Services Committee is mulling a separate proposal from Rep. Linda Sanborn, D-Gorham, to expand access to Medicaid, the federal health care program for the poor.
LePage has said he is ideologically opposed to expanding Medicaid, but he engaged the federal government in talks on the issue after a number of Republican governors in other states said they were open to it.
In a March letter to U.S. Health and Human Services Secretary Kathleen Sebelius, he asked the federal government to fund 100 percent of expansion costs, citing explosive growth in the program since 2002. Bennett said the administration hasn’t gotten an answer on that proposal.
An analysis by the Kaiser Family Foundation has projected that Maine will save $690 million in the next 10 years if it accepts federal dollars under the Affordable Care Act to provide care to approximately 55,000 Mainers.
In a statement Friday on the latest Democratic proposal, House Speaker Mark Eves, D-North Berwick, said linking hospital repayment with Medicaid expansion “will cover more Mainers, save the state and hospitals money, and boost our economy.”
“This is a common-sense marriage of ideas. It's important to approach health care in a comprehensive way that both addresses past obligations but also reduces costs and expands coverage going forward,” Eves said. "To do one without the other would leave our work only half done.”
But Republican legislators have been wary of expansion, and House Minority Leader Kenneth Fredette, R-Newport, said the timing of Democrats’ proposal is troubling.
“Any attempt to couple Medicaid expansion with repayment of the hospitals simply will not happen in the next eight weeks,” Fredette said, referring to the end of the legislative session in June. “We’re putting the repayment of the hospitals at risk.”
This story will be updated.