March 27, 2013

Maine Hospital Association backs Medicaid expansion

By Steve Mistler
State House Bureau

AUGUSTA — The organization representing Maine's hospitals voiced its support Wednesday for Medicaid expansion, adding a political force to the debate over making government-funded health insurance available to more low-income Mainers.

Jeff Austin, the lobbyist for the Maine Hospital Association, said in a written statement that hospitals are still evaluating the fiscal impact of expansion but are generally supportive.

"Based upon the best information we have available, we are presuming that Medicaid expansion will not cost the state too much money," he wrote, adding that his group hopes the state will provide more data on the fiscal impact.

Hospitals are considered a key voice in the debate over expanding MaineCare, the state's Medicaid program, under the federal Affordable Care Act. They have been instrumental in states that have chosen to increase Medicaid eligibility, particularly states with Republican governors.

Until recently, the Maine Hospital Association said it was interested in expansion but did not express outright support.

Its position was announced Wednesday by Democratic legislative leaders, who met with the hospital group. The association later issued its own statement.

House Speaker Mark Eves, D-North Berwick, said it was encouraging to see hospitals joining "a growing chorus" supporting expansion.

"We need their support," Eves said.

Democrats have reaffirmed their commitment to pay the $484 million that Maine hospitals are owed in Medicaid reimbursements. The figure includes about $184 million in state funding, which would trigger the release of about $300 million in federal funds.

Senate President Justin Alfond said, "We've been working hard with (the hospitals) to ensure that their debt gets paid back. We've also been working hard with them to ensure that more Mainers have basic health care in the state of Maine."

The expansion would make 55,000 more low-income people eligible for MaineCare, according to an analysis by the Kaiser Family Health Foundation.

Those people would be "able-bodied" parents, and adults who have no children and earn as much as 133 percent of the federal poverty level -- just over $20,500 a year for a two-person household.

Gov. Paul LePage has expressed willingness to participate in Medicaid expansion. His administration is seeking what the governor calls "the best deal for Mainers."

The administration has told the Obama administration that Maine will consider participating in the expansion if the federal government pays for affected recipients for 10 years.

The proposal, outlined in a letter to U.S. Health and Human Services Secretary Kathleen Sebelius, is effectively LePage's counterproposal to the federal government's plan to fully fund Medicaid expansion from 2014 through 2016 and cover 90 percent of the program from then on.

In the letter to Sebelius, Maine Health and Human Services Commissioner Mary Mayhew said the state has been penalized for voluntarily expanding Medicaid eligibility in 2003. She said that because federal reimbursement rates for some Medicaid recipients have since decreased, other states are getting a better deal for participating in the expansion than Maine would.

Democratic leaders have said the governor's proposal isn't likely to win approval but they are encouraged that LePage is looking to accept federal dollars to expand Medicaid in Maine.

The state is projected to spend $776 million on MaineCare in the fiscal year ending June 30. That's 25 percent of its overall budget.

Counting federal money, nearly $2.4 billion will be spent on MaineCare this year.

Support from the state's 39 hospitals broadens the coalition calling for expansion and adds a heavyweight to the debate.

Other backers include the Maine Medical Association, the group representing the state's doctors.

Hospitals generally support increasing Medicaid eligibility because it holds the promise of reducing the number of uninsured and the amount of charity care that hospitals provide.

Austin said the association will testify Tuesday on L.D. 1066, the Democrats' Medicaid expansion bill. The measure is sponsored by Rep. Linda Sanborn, D-Gorham, a retired family physician.

Steve Mistler can be contacted at 620-7016 or at:


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