May 22, 2013

Hospital payback, Medicaid expansion hinge on LePage

The House and Senate approve a bill that would pay state hospitals back $186 million, and give basic health coverage to 60,000 Mainers using federal dollars.

By Steve Mistler smistler@pressherald.com
Staff Writer

(Continued from page 1)

They say it is unrealistic to expect the federal government to reimburse states for 90 percent of the expansion, as promised, after paying 100 percent of the cost from 2014 to 2016.

On Tuesday, Rep. Richard Malaby, R-Hancock, said the program encourages recipients to "overconsume and undervalue" insurance. And he said hospitals exploit the program and overbill for services.

Rep. Lawrence Lockman, R-Amherst, said the program is unsustainable and contributes to the country's fiscal woes. He said the United States is the most bankrupt country, and expanding Medicaid will saddle future generations with debt.

"Why should my grandchildren not view you as a thief?" Lockman said.

Other Republicans said they are open to Medicaid expansion, but not combined with the hospital bill.

During the Senate debate Tuesday morning, Sen. Doug Thomas, R-Ripley, said linking the popular hospital plan to Medicaid expansion doesn't make sense.

"If Medicaid is such a good idea, why do we have to tie it to such a popular proposal? Why can't it stand on its own merits?" Thomas said. "Is it because it's not as good a proposal as we're being told?"

Democrats say the combination would erase the hospital debt while reducing charity care and emergency room visits.

"We all know that people using emergency rooms for their health care are driving up costs," said Sen. Seth Goodall, D-Richmond.

Republicans said linking the two plans jeopardizes both.

Sen. Roger Katz, R-Augusta, has said that some Republicans are open to Medicaid expansion but need to know more about the long-term consequences and allow LePage to continue negotiating a deal with the Obama administration.

The administration has given some Republican governors additional flexibility over their respective Medicaid programs in exchange for participating in expansion. However, Democrats say LePage's counterproposal is a non-starter and are not convinced that the governor is genuinely bargaining.

Democrats said the combined proposal is a win for hospitals and low-income Mainers. The nonpartisan Office of Fiscal and Program Review estimates that an additional 50,000 residents would qualify for Medicaid coverage. If the state doesn't expand Medicaid, about 25,000 childless adults and parents will lose insurance on Jan. 1.

According to the Congressional Budget Office, the expansion would cover non-elderly adults earning as much as 133 percent of the federal poverty level, just over $20,500 a year for a two-person household.

The office estimated that 49 percent of those affected by expanded Medicaid eligibility earn $5,745 a year or less.

The same study estimated that 37 percent of the people who would gain coverage would be 35 to 54 years old, and 11 percent would be 55 to 64.

Steve Mistler can be contacted at 620-7016 or at:



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