Tuesday, December 10, 2013
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.
TUNE IN TODAY
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.
OTHER ISSUES WAIT
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.
Administration officials, meanwhile, say they are moving forward with their own health care management efforts, including a joint effort with hospitals, and are building those savings into the budgets. Those savings won't solve the short-term funding crisis in MaineCare, they say.
Republicans on the Appropriations Committee, meanwhile, are welcoming ideas for reducing costs, including care management.
"We'll certainly take a look at that," said Sen. Richard Rosen, R-Bucksport, who co-chairs the committee.
GAY MARRIAGE VOTE LOOMS
When it comes to gay marriage, support among voters appears to change based on how the question is worded, recent polling results show.
Public Policy Polling surveyed 1,256 Maine voters March 2-4 using automated telephone interviews. They found that 47 percent of those surveyed would vote "yes" on the question as it will appear on the November ballot:
"Do you favor a law allowing marriage licenses for same-sex couples that protects religious freedom by ensuring no religion or clergy be required to perform such a marriage in violation of their religious beliefs?"
That leaves 32 percent voting "no" and 21 percent "not sure."
When the question is asked more simply: "In general, do you think same-sex marriage should be legal or illegal?" -- 54 percent said "legal" and 41 percent said "illegal" -- leaving 5 percent unsure.
Opponents of same-sex marriage have argued in recent weeks that Mainers haven't changed their minds, and the polling results on the first question bear that out -- at least among the percentage expressing support.
It was 47 percent in 2009, and remains that today.
But the 21 percent who said they were "not sure" will surely hearten supporters, who will work until November to move them into the yes column.
A LEGISLATIVE SWING?
The same poll asked voters if the election were held today, would they "generally vote for Democratic candidates or Republicans?"
Fifty-one percent said Democrats, 37 percent chose Republicans and 13 percent were not sure. It is worth noting that of those surveyed, 43 percent self-identified as Democrats, 34 percent said they were Republicans and 23 percent chose independent/other.
While that might give Democrats hope of taking back the House and Senate, the poll can't capture an important factor in Maine's 186 legislative races -- that they are essentially hyper-local battles where people often look beyond party, especially if their neighbor is running for office.
It's no secret that negotiations between the Maine State Employees Association and the LePage administration have been contentious.
Dueling news releases following a somewhat routine finding by the Maine Labor Relations Board bear that out.
Last week, the board's executive director ruled that there is enough evidence of "bad faith" bargaining tactics to call for a hearing. The union says the administration walked out of negotiations at a critical time, refused to bargain seriously until the contract was nearly up, and demanded "extreme concessions."
And while that one issue will move forward, MLRB Executive Director Marc Ayotte rejected other accusations by the union, including charges of discrimination.
That led the union to put out a news release with the headline "LePage administration to stand trial for negotiating in bad faith." There will be a hearing before the board.
Later that day, the administration put out a news release that says the board "rejects claims" by the MSEA.
At the end, it does acknowledge that the administration "expected from the beginning" that it would have to defend itself at a hearing.
"This case appears to be an expression of MSEA's frustration that the voters of Maine elected a governor who has given priority to restoring fiscal health to the state of Maine, a priority it appears MSEA may not share," said Julie Armstrong, a state attorney.
MaineToday Media State House Writers Susan Cover and John Richardson contributed to this column.