WASHINGTON – The political fight over Maine’s Medicaid programs continued Wednesday as Gov. Paul LePage accused U.S. Rep. Chellie Pingree of becoming “part of the jet-setting Washington culture that keeps people dependent on government handouts.”

Pingree, in turn, refused to halt her vocal opposition to cutting a program that provides health care to low-income Mainers.

The dispute centers on whether about 27,000 Mainers should lose their Medicaid eligibility as part of an effort by LePage, with support from a divided Legislature, to balance the state’s budget.

Critics of the cut say lower-income residents can ill afford to lose health care benefits. Conservatives argue that the state has to scale back the program if it wants to be fiscally responsible.

In an escalation of tension over the issue, LePage blasted Pingree for a letter she sent this week to President Obama’s health secretary, Kathleen Sebelius. The governor said the letter was “careless in its facts” and failed to mention that the proposed cuts to Medicaid were approved by the Legislature.

“If you would like to attack me personally, fine, but it is irresponsible and a disservice to Maine people to try and hide the facts from a (Cabinet) secretary,” LePage, a Republican, wrote Wednesday in a letter to Pingree, a Democrat.

Pingree responded Wednesday afternoon that she is representing the tens of thousands of Mainers who stand to lose their health coverage through Medicaid if the cuts are enacted.

“I didn’t mean to be in a personal dispute with the governor but I’m not going to back down on my opinion on this,” Pingree said in an interview.

On Monday, Pingree wrote a letter to Sebelius, urging her and the U.S. Department of Health and Human Services to review Maine’s plan to remove some residents from MaineCare, the state’s Medicaid program. Pingree opposes the cuts.

The dispute lies in differing interpretations of the U.S. Supreme Court’s ruling last month on the Affordable Care Act, Obama’s landmark health care law. It also underscores how deeply partisan the debate over the law continues to be, despite the court ruling largely upholding it.

The LePage administration and Maine Attorney General William Schneider argue that the ruling means Maine no longer needs a special waiver from the DHHS to enact cuts to Medicaid that were built into the state budget.

The DHHS has never issued a “maintenance of effort waiver” to a state to scale back a Medicaid program, and Maine’s application for one has been widely viewed as a long shot.

On Tuesday, Sebelius sent a letter to all 50 governors that did not specifically mention the waiver issue. She wrote that the court clearly said the federal government could not impose severe financial penalties on states that refuse to expand Medicaid, as required by the controversial law. But she said “the court’s decision did not affect other provisions of the law.”

A spokesman for the DHHS declined to comment on or clarify the waiver issue on Wednesday. But the non-specific phrase about “other provisions of the law” was enough for Pingree and other critics of the proposed Medicaid cuts to declare that Maine still needs a waiver.

“We do think that her statement last night clarifies the issue,” Pingree said.

Neither LePage’s nor Schneider’s offices commented Wednesday on Sebelius’ letter.

Pingree is married to financier S. Donald Sussman, a contributor to Democratic and charitable causes and the majority share owner of MaineToday Media, which owns the Portland Press Herald/Maine Sunday Telegram, the Kennebec Journal in Augusta, the Morning Sentinel in Waterville and other media outlets in Maine.

The waiver has been an issue in Maine for months, since LePage and Republican lawmakers approved changes to the eligibility requirements for MaineCare as a way to balance the state budget.

Over strong objections from Democratic lawmakers, Republicans voted to eliminate Medicaid coverage for senior citizens and people with disabilities in the Medicare Savings Program, 19- and 20-year-olds, and parents whose income is 100 percent to 133 percent of the federal poverty level.

LePage criticized Pingree’s portrayal of the cuts as drastic, instead calling them a “necessary correction” to Maine’s history of overpromising welfare benefits and becoming a “welfare state.”

The governor sent a separate letter to Sebelius, in which he called Pingree’s earlier letter an “opinion piece” and urged the DHHS to objectively consider an upcoming Medicaid amendment request from Maine. The amendment is regarded as posing a lower threshold to approval of the cuts than the maintenance of effort waiver.

In his letter to Pingree, LePage said he found it “astounding that you would actively advocate for the federal government to overrule Maine decisions.”

“Your title says that you are a Representative from Maine, but apparently you prefer to represent the power of bureaucrats in Washington, D.C.,” LePage wrote.

Pingree’s Republican challenger in the November election, state Sen. Jonathan Courtney of Springvale, accused her of acting without consulting Maine leaders and without considering how it will affect attempts to balance the state budget.

In an interview in her House office, Pingree said she has had several conversations about the issue with the governor and he was well aware of her position. She also noted that the Medicaid cuts were approved as part of a budget that Republicans passed on a simple majority vote, rather than through the two-thirds majority typically sought for Maine budgets.

She defended her decision to ensure that the DHHS reviews the proposed cuts through the waiver process, saying her office hears regularly from elderly and disabled people who are concerned about losing coverage.

“I don’t want to be in a personal fight with him,” Pingree said. “I am sympathetic to the (budget) challenges that he is facing, but I see it differently. And I disagree with him on our roles. I represent the entire 1st Congressional District of Maine and I feel my job is to make sure I speak up for the people who are going to lose their health care in a tough economic time.”

Pingree said the health care law was thoroughly debated, then vetted by the Supreme Court, and “now it is our job to move forward and implement it.”

Washington Bureau Chief Kevin Miller can be contacted at 317-6256 or at:

kmiller@pressherald.com

Twitter: @KevinMillerDC