WASHINGTON — Gov. Paul LePage said Monday he is “cautiously optimistic” that the Obama administration might allow Maine to place new restrictions on Medicaid eligibility and spending.

LePage and other governors met Monday at the White House with President Obama on the final day of the National Governors Association winter meeting here.

Obama told the governors he is willing to work with states on allowing more flexibility over how to run Medicaid, a state-federal health care program for the poor that is known as MaineCare in Maine, under the terms of the new health care reform law.

LePage said the state may be “making some headway” when it comes to being allowed to drop some adults from the MaineCare rolls and spend less money on other adults.

Currently, the state covers “family related adults” — those in households with children — who earn up to 200 percent of the poverty level. LePage wants to limit that health coverage to adults earning no more than 133 percent of the poverty level. Children in those households would still be covered up to 200 percent of the poverty level under a combination of MaineCare and a similar children’s insurance program.

The new federal health care law only mandates covering those who make up to 133 percent of the poverty level. But the law also prevents states from adopting standards less generous than what they currently have.

LePage also wants to cut how much the state spends on childless adults, who qualify for MaineCare if they earn 100 percent or less of the poverty level.

Maine could save tens of millions of dollars a year by making these changes to coverage and eligibility for some adults under MaineCare, LePage said.

When interviewed in Washington on Saturday, LePage referred to wanting to cut the eligibility standards for childless adults. But his administration clarified that Monday, saying there were two categories of adults being considered for MaineCare changes — childless adults and family related adults. Family related adults would have eligibility cut to 133 percent from 200 percent of the poverty level. The administration has not yet specified how it would cut spending on childless adults.

A single person is considered to be at 100 percent of the current federal poverty guideline if he or she earns $10,890 or less annually, according to the Department of Health and Human Services.

Critics of LePage’s proposals say veterans, homeless people and the working poor would be among those harmed, and that hospitals and other health care providers would assume increased costs.

About eight states have Medicaid benefits of more than 133 percent of poverty level for some recipients and are considering trying to scale them back, according to the governors association.

LePage said he spoke during the three-day meeting with Obama administration staff about his desire to restrict MaineCare benefits, and that his administration will continue communicating with federal officials.

“They are going to consider that,” LePage said. “They are going to work with us on that.”

A spokeswoman for the federal Centers for Medicare and Medicaid Services referred to a letter sent to all state Medicaid directors last week.

The letter indicates that the Obama administration will consider exempting states from some current requirements if a state can show it is in financial trouble.

LePage has noted that the state is struggling to close nearly a $1 billion budget shortfall. He said in Monday’s interview that being given the authority to change the eligibility level for MaineCare is “very, very critical for Maine.”

Washington Bureau Chief Jonathan Riskind can be contacted at 791-6280 or at: jriskind@mainetoday.com

 

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