Where the States Stand
Via: The Advisory Board Company

November 17, 2012

LePage defies key parts of Obamacare

Maine’s governor won’t implement a state-customized online insurance exchange or participate in a Medicaid expansion.

By Steve Mistler smistler@pressherald.com
Staff Writer

(Continued from page 1)

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Staff photo by Andy Molloy STORM TOUR: Gov. Paul LePage tours the Maine Emergency Management Agency in Augusta on Monday.

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Read the text of Gov. Paul LePage's letter to HHS Secy. Kathleen Sebelius

LePage isn’t the only governor to pass on Medicaid expansion. Six other Republican governors have said definitively that they’re taking a pass, while five others are leaning in that direction, according to an analysis by The Advisory Board Company, a health care consulting firm.

Maine could become the only holdout in New England. New Hampshire has indicated that it’s likely to participate, while Massachusetts, Connecticut, Vermont and Rhode Island have already committed to expansion.

States that agree to expansion would extend Medicaid eligibility to nearly all individuals with incomes up to 133 percent of the federal poverty level. A single person earning as much as $14,856 a year would receive health insurance, and a family of three earning as much as $25,390 would be covered, according to statistics compiled by the Kaiser Family Foundation.

Advocates for expansion argue that increased Medicaid eligibility saves money because it would discourage needy residents from getting charity care in hospital emergency rooms. Charity care is often funded through higher premiums for those with private insurance.

Charity care is also a concern for hospitals.

Uncompensated care – health care costs that hospitals absorb because people can’t or won’t pay – soared nationally from a total of less than $5 billion to nearly $40 billion from 1980 to 2010, according to the American Hospital Association.

The Portland Press Herald reported that uncompensated care by Maine hospitals has doubled over the past five years, from $94 million to $194 million.

It’s unclear whether LePage’s decision is supported by the Maine Hospital Association, the trade group representing Maine’s hospitals. A spokesman for the group did not immediately return a call seeking comment.

Jeffrey Austin, a spokesman for the group, told the Press Herald in July that increased Medicaid eligibility would lower costs for uncompensated care, but hospitals often end up paying for expanded Medicaid programming through reduced federal reimbursements.

However, at the time, Austin said the association may still end up advocating for the expansion.

Staff Writer Steve Mistler can be contacted at 791-6345 or at:



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Today's poll: Health care

Do you agree with Gov. Paul LePage’s decision not to implement a state-based insurance exchange?



View Results