March 12, 2012

State House Notebook: MaineCare debate will not go away

By Susan M. Cover
State House Bureau

AUGUSTA — The state's Medicaid system, MaineCare, has dominated debate at the State House since December, when Gov. LePage proposed cutting more than 65,000 Mainers from the health insurance program to balance the budget. It looks like it will stay that way for a while.


MaineToday Media State House Writer Susan Cover will be on NewsRadio 560 WGAN at 8:08 a.m. today to talk about what's going on at the State House.

On Friday, the latest MaineCare crisis led to a congressional-style inquiry by the Legislature's Appropriations Committee. Members grilled and scolded Health and Human Services Commissioner Mary Mayhew over the revelation that the state paid medical claims for as many as 19,000 ineligible patients from September 2010 to January of this year. Mayhew informed the Legislature last week, but said she won't know for several more weeks how much the state lost because of the computer error, or how much may have to be repaid to the federal government. The feds pay roughly two-thirds of Medicaid claims, and the state pays the other third.

Democrats who reluctantly agreed last month to cut MaineCare coverage for about 14,000 people to balance this fiscal year's budget demanded to know why Mayhew didn't tell them in January that the state had been overspending and the budget figures were in doubt.

"Critical information was withheld from us at a time when we were making tough decisions about health care for our most vulnerable -- the elderly, the disabled and children," Rep. Peggy Rotundo, the lead Democrat on the Appropriations Committee, said in a written statement Friday.

Republicans also were frustrated about the problem, which has complicated efforts to balance the budget for 2012-13.

Mayhew said she didn't have enough information about the problem until a little more than a week ago, when she told LePage. She also defended members of the department who failed to tell her about the problem for months, she said, because they were struggling with numerous computer problems.

"As commissioner, I am responsible," she told the committee.

Mayhew, a Democrat and a former lobbyist, seemed unfazed by Friday's inquest. After two hours of questioning and lecturing, she was asked if she wanted a break.

"Has it been that long?" she said, saying she preferred to keep going.

An hour or so later, she emerged to answer another round of questions in the hallway, surrounded by television cameras.

While some critics have suggested that Mayhew resign for withholding information, LePage issued a statement late Friday backing his commissioner.

"I have the utmost confidence in the ability of Commissioner Mayhew. In the past year, the commissioner has displayed a level of professionalism that speaks volumes. She is compassionate about serving our state and her ability to deal with the complexity of these issues is commendable. She has been open and honest throughout this difficult process," LePage said.


Before the latest MaineCare crisis erupted, lawmakers were preparing to take up a nearly $100 million shortfall in the program's 2012-13 budget. They may have no choice but to move forward this week, given that the scheduled end of the session is about one month away.

Democrats hope to turn this budget-balancing debate away from cutting off coverage to thousands of additional people and focus instead on cutting wasted medical costs.

"Five percent of the users in MaineCare represent 55 percent of the cost," said Rep. Mark Eves, D-North Berwick.

Eves said the state can save millions next year by focusing efforts on keeping chronically ill people healthier and making sure they visit primary care doctors instead of emergency rooms.

Eves said the LePage administration should reconsider its decision last year to scrap plans to hire a managed care contractor to oversee MaineCare claims. "We lost a lot of time and money because of that," he said.

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