Gov. Paul LePage blamed lawmakers for his refusal on Tuesday to begin securing federal funding needed to expand Medicaid to well over 70,000 low-income residents.

The Republican governor did not meet a deadline laid out in the 2017 voter-approved law to submit a routine application to ensure the state receives roughly $500 million in annual federal funding for expansion by July 2.

LePage spokeswoman Julie Rabinowitz said she believed the application could be submitted “very quickly” if lawmakers provided the state’s share of funding for expansion under the governor’s terms.

The lack of action by the LePage administration and lawmakers leaves tens of thousands of lowincome residents in limbo. The expansion would apply to residents who earn up to 138 percent of the federal poverty limit, about $28,000 for a family of three.

LePage for months has said he would not take any steps to expand Medicaid until lawmakers provide “sustainable,” long-term funding without raising taxes, dipping into the rainy day fund or using budgetary gimmicks. The governor also wants money for individuals with developmental disabilities awaiting services.

Democrats and pro-expansion advocates said the governor does not need extra funding to file a simple application. They argued he is ignoring the law and pitting Mainers against each other.

“It’s a false choice,” said Lewiston resident Donna Wall, who cares for three adult children with autism and does not yet qualify for Medicaid coverage. “The governor is prioritizing tax breaks ahead of affordable health care for all Mainers.”

Lawmakers are beginning to debate using roughly $140 million in projected surplus revenue for Medicaid expansion, LePage’s proposed tax relief and other areas. Democratic attorney general and gubernatorial candidate Janet Mills said lawmakers also could use $35 million in extra tobacco settlement funds.

Months after LePage laid out his demands, key disagreements remain over how much Medicaid funding is needed, and when lawmakers need to provide it. The Legislature’s joint appropriations committee on Thursday is set to hold lawmakers’ first public meeting in months on expansion.

The governor is blaming lawmakers, who he said have not funded Medicaid’s first year of expansion, which his administration estimates will cost Maine about $58 million, including $8 million for 105 staffers to manage expansion. The LePage administration has denied estimates that Maine will see annual savings between $25 and $27 million.

“Gov. LePage has stated it would be irresponsible to open up Medicaid enrollment when the program hasn’t been funded,” Rabinowitz said. “We should not make a down payment without a plan to pay for the ongoing cost.”

Democratic House Speaker Sara Gideon of Freeport said LePage must address unanswered questions, including the number of unfilled positions in the Department of Health and Human Services, before lawmakers fund new staffers.

LePage’s office also denied statements lodged by critics that Maine has the money to cover much of the first year of Medicaid expansion. Luke Lazure, an analyst for the non-partisan Office of Fiscal and Program Review, said his analysis shows Maine can pay Medicaid expansion bills through May 2019.

“Contrary to what the expansion supporters claim, the funding already allocated is not enough to pay the bills for tens of thousands of new enrollees for fiscal year 2019,” said Rabinowitz, who didn’t provide the status of the state’s current Medicaid funds.

Meanwhile, LePage has claimed President Donald Trump’s administration told him that federal officials will not approve Medicaid expansion funding unless Maine lawmakers show they have the money.

Questions about how Maine would fund its share could come up during a federal

90-day review of its funding application, according to a U.S. Centers for Medicare and Medicaid Services spokesman.

But typically, the federal agency only gets into such questions if a state is proposing to fund expansion with a tax on health care providers, said Robin Rudowitz, associate director for the Kaiser Family Foundation’s Program on Medicaid and the Uninsured.

Pro-expansion groups warn of a lawsuit if the governor prevents expansion demanded by 59 percent of voters last November.

“No matter how much the governor tries to talk his way around his legal obligation, we’re not going to back down from what is right,” Maine Equal Justice Partners Executive Director Robyn Merrill said.

Missing Medicaid

THE LACK OF action by the LePage administration and lawmakers leaves tens of thousands of low-income Mainers in limbo. The Medicaid expansion would apply to residents who earn up to 138 percent of the federal poverty limit, about $28,000 for a family of three.

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