Wednesday, May 22, 2013
BOSTON — A federal appeals court on Thursday rejected Maine's request to speed the federal government's decision on whether to allow $20 million in cuts to the state's Medicaid program.
Gov. Paul LePage
Maine had filed what's known as a state plan amendment with the U.S. Department of Health and Human Services on Aug. 2 and requested a decision by Sept. 1 so that its proposed changes could be implemented immediately and balance the state budget.
The changes to MaineCare, the state's version of Medicaid, would eliminate health care benefits for 24,000 low-income parents, nearly 7,000 19- and 20-year-olds, and 1,800 Medicare recipients who receive additional benefits under MaineCare.
On Aug. 31, the federal DHHS sent a letter to Gov. Paul LePage saying it needed more time to consider the state's request. Federal law allows 90 days, which means a decision could be issued as late as Oct. 31.
"I appreciate that your budget is predicated on the savings anticipated from ending the Medicaid coverage of the groups of individuals at issue in the proposed (plan), but your request raises issues that require careful consideration," Marilyn Tavenner, acting commissioner of the DHHS's Centers for Medicare and Medicaid Services, wrote in the letter to the state.
Maine Attorney General William Schneider, responding on behalf of the state's health and human services commissioner, Mary Mayhew, responded by filing a complaint in the U.S. 1st Circuit Court of Appeals in Boston on Sept. 5. He urged the court to require the Centers for Medicare and Medicaid Services to act sooner because Maine would "suffer irreparable injury" without a swift decision.
On Thursday, the three-judge appeals court summarily denied Maine's request, writing that "the facts do not warrant" an expedited review of its state plan amendment.
Adrienne Bennett, spokeswoman for Gov. Paul LePage, declined to comment on the ruling. LePage is out of the country, on a trade mission to China.
Brenda Kielty, a spokeswoman for the Attorney General's Office, also declined to comment.
Sara Gagne-Holmes, executive director of Maine Equal Justice Partners, an advocacy group that has opposed the MaineCare cuts, said the court's decision shows that state officials were "without merit to even bring a complaint."
"They knew when they passed this budget that it would be unlikely that Maine would get a waiver," she said. "They took a high-stakes gamble and lost."
Democrats, who last week called the lawsuit "pure politics," were pleased with the court's decision.
"Democrats agree with the court's decision to let the federal government carry out its due diligence in evaluating these proposals that will impact health care for nearly 30,000 Maine people," House Minority Leader Emily Cain, D-Orono, said in a prepared statement.
The MaineCare cuts, passed by the Republican-controlled Legislature this spring, are scheduled to take effect Oct. 1. The state has been moving forward with plans to make the changes. It published legal ads in the Portland Press Herald in early August giving formal notice of the changes. If federal officials do not respond by Oct. 1, the state could be forced to put the cuts on hold.
LePage and his allies have contended that the U.S. Supreme Court's ruling in June on the Affordable Care Act gives states more flexibility to make Medicaid changes and eliminates the need for a waiver from federal requirements.
A recent opinion from the Congressional Research Service, which works as a think tank for Congress, concluded that the Supreme Court's decision did not change the waiver requirement.
To date, the federal DHHS has not approved a Medicaid waiver for any state.
Staff Writer Eric Russell can be contacted at 791-6344 or at: