LEWISTON – While there continues to be significant debate inside the Beltway about the economic stimulus bill — known officially as the American Recovery and Reinvestment Act of 2009 (ARRA) — there is no doubt outside the Beltway, here in Maine, that a key provision of ARRA temporarily boosting state Medicaid assistance has made a significant difference in terms of preserving access to quality health care and community services essential to maintaining a healthy lifestyle.

The economy and the threat of an end to funding for an increase in Medicaid’s Federal Medical Assistance Percentage (FMAP) is already affecting our communities, our schools, our hospitals, our skilled nursing centers, our mental health services, our state employees, our attitude and morale.

Even as we tighten our belts, implement furlough days, lay off our teachers and cut back on essential community services, Congress has yet to pass an extension of this provision vitally needed right now to truly protect American citizens.

As part of ARRA, Congress enacted a temporary increase in the FMAP for all states in an effort to protect vulnerable populations in the midst of our deep, enduring recession. As the bipartisan National Governors’ Association notes, “Funding for FMAP is a particularly effective countercyclical tool because it immediately allows governors to eliminate planned budget cuts required to meet balanced budget requirements and continue services for those with the greatest need.”

Governors across America, facing a sea of state budget red ink, well understand the temporary FMAP increase is vital to protecting, for example, Maine’s aging population’s ongoing access to the skilled nursing and rehabilitative care they may require in order to live comfortably.

Considering the squeeze on health care services caused by federal Medicare cuts of nearly $27 billion over 10 years, FMAP helps serve as the critical difference protecting both seniors and the very jobs of the front line caregivers who make the qualitative difference in patient outcomes.

Unfortunately, however, the FMAP increase expires on Dec. 31 — which is the middle of Maine’s fiscal year. As this issue remains unresolved, and governors from coast to coast remain uncertain federal lawmakers will extend the temporary assistance, setting a state budget has become problematic. Consequently, additional state Medicaid cuts could be on the drawing board.

For Maine’s seniors and those who provide their care, it is essential for Congress to extend until June 30, 2011, the enhanced FMAP. Despite the fact the U.S. Senate and House have passed legislation extending the FMAP increase, final action on this vital issue remains to be taken.

The National Association of State Budget Officers places the continuing state fiscal crises in the proper alarming context by recently reporting states face a collective $55.4 billion shortfall in current budgets, and a combined $136.1 billion in deficits over three years.

This is simply not an eldercare financing crisis that can be papered-over or pushed to the policy back burner. Congress must act, and act now.

Adequate, stable and consistent Medicare and Medicaid funding was and always will be directly linked with high quality care and staffing and employment stability.

Elderly Mainers residing or recuperating in skilled nursing facilities across our state need and deserve immediate help, and Gov. John Baldacci desperately requires extended federal financial assistance to help bridge the funding gap as our state economy recovers.

Extending FMAP assistance an additional six months is a fundamental, central step towards protecting the foundation of quality care every Maine resident deserves, and preserving the jobs of the front line care staff that help improve Maine’s seniors’ quality of life.

We urge our congressional delegation in the strongest possible terms to fight for continued funding for FMAP.