February 17

State House Notebook: Maine DHHS argument against Medicaid expansion pivots from Alexander study

Also: Republicans charge House Speaker with conflict of interest.

By Steve Mistler smistler@pressherald.com
Staff Writer

As the debate over Medicaid expansion rages in the Legislature, the LePage administration is rolling out a coordinated effort among state agencies to focus on the program’s “cannibalizing” of their respective budgets.

click image to enlarge

Messages between high-level staff at the Department of Health and Human Services, including Commissioner Mary Mayhew, show how the agency is trying to ramp up its argument against expansion of MaineCare.

2014 Press Herald File Photo

The administration also appears to be pivoting from the taxpayer-funded study that it originally hoped would bolster its anti-expansion position.

Hints of the two-pronged strategy were included in a series of emails inadvertently forwarded to a reporter at the Portland Press Herald. The messages between high-level staff at the Department of Health and Human Services, including Commissioner Mary Mayhew, show how the agency is trying to ramp up its argument against expansion of MaineCare, as Medicaid is called in Maine.

The administration’s anti-expansion case was expected to lean heavily on what’s known as the Alexander Group report, which has already cost the state $185,040 for a Medicaid expansion feasibility study. The report, included in a $925,000 no-bid contract for Gary Alexander, the former welfare chief for Pennsylvania, has been under siege since its release Jan. 10. A national health care analyst said the report contained a $575 million calculation error, omitted savings measures and overstated poverty projections that could balloon the costs of expansion.

While Democrats plan to submit a bill that would nullify the contract, the emails show how officials at DHHS are weighing whether to defend Alexander’s Medicaid study or divert attention from it. On Feb. 11, DHHS spokesman John Martins emailed Mayhew, Sam Adolphsen, the deputy finance director, and Nick Adolphsen, a legislative liaison. He discussed a memo from Erik Randolph, a member of the Alexander Group, that presumably defended the Medicaid study. Sam Adolphsen wrote Friday that he liked the memo, but questioned whether the agency should wait for the “next attack” to make it public.

Martins replied: “We are succeeding on all fronts on getting the expansion message out and the focus on the (Alexander Group) report has died down.”

Martins went on to request “quotable and reliable data” to support the administration’s claim that Medicaid expansion recipients could qualify for subsidies in the federal health care law. He noted that communications directors “across the state have been asked to do (newspaper opinion columns) regarding the impact of Medicaid spending on their programs.”

He concluded: “We haven’t lost anything – we have this (memo) ready for the next salvo – but I think if we have data, especially data that we can report as new, Commissioner, we can accomplish your message objective without tying it to the (Alexander Group) report.”



Last week, 26 House Republicans signed a letter requesting that House Speaker Mark Eves, D-North Berwick, recuse himself from voting on a bill that would expand Medicaid, the publicly funded health insurance program for the poor.

The Republicans claimed that Eves had a conflict of interest because he works for Sweetser, a behavioral health care organization that receives Medicaid funding.

Eves, whose job at Sweetser is to coordinate care for adults and children with doctors and nurses, said he would not receive a financial benefit from Medicaid expansion.

His alleged conflict has swirled in conservative circles for nearly a year and been flogged with some vigor by the purported news service of the Maine Heritage Policy Center, an advocacy group that opposes expansion and is currently running Facebook ads targeting Republican lawmakers who are considering voting for it. Until last week, the complaints about a conflict have mostly come from MHPC and the governor’s office, which has encouraged reporters to write about it.

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