Superior Court Justice Michaela Murphy, seen in March, said Thursday that voter-approved Medicaid expansion “is in effect. It’s not a suggestion. … The executive branch has a duty to enforce that.”

Superior Court Justice Michaela Murphy said Thursday that she will issue a ruling as soon as possible in a lawsuit against the state over implementation of Medicaid expansion, which Maine voters approved last year.

At issue is whether the state Department of Health and Human Services must file paperwork with the federal government as outlined in the law.

James Kilbreth, an attorney representing Maine Equal Justice Partners, the low-income advocacy organization that filed the lawsuit, argued that the state missed its April 3 deadline to file what’s known as a state plan amendment that would start the process of expanding the government-funded health care program.

In November, voters approved expansion with 59 percent support, making Maine the first state to expand the program by referendum.

Kilbreth urged Murphy to force the state to file its amended plan and also to begin creating rules ahead of another deadline – July 2 – when newly eligible people will be able to apply for Medicaid benefits.

“We are well past whatever date you pick,” he said. “This is critically important to 70,000 people. We need to get this moving.”


Patrick Strawbridge, an attorney representing DHHS and the LePage administration – which has fiercely opposed Medicaid expansion for years – argued that the state cannot submit a plan without an appropriation of funding. That hasn’t happened, and the Legislature has adjourned.

“Committing to that plan is committing to spending money,” he said.

Strawbridge, a Boston-based attorney, represented the administration because Maine Attorney General Janet Mills, now a Democratic candidate for governor, declined to make anyone from her office available.

Justice Murphy didn’t hint which way she was leaning, but she seemed uninterested in wading into the political stare-down between the executive branch and the Legislature. This lawsuit is just the latest in a string of examples where the failure of LePage and lawmakers to find consensus has led to a court battle.

Murphy was unequivocal about one thing, though.

“The law is in effect. It’s not a suggestion,” she said. “The executive branch has a duty to enforce that.”


LePage and his allies have acknowledged, begrudgingly, that Medicaid expansion is law, but have said their hands are tied until funds are specifically appropriated. Medicaid is funded mostly at the federal level, but the state of Maine is required to contribute its own funds. Thirty-one other states already have expanded Medicaid under the provisions of the Affordable Care Act.

The fight over how to fund the expanded program hung over the contentious final days of the most recent legislative session, which ended without passage of a supplemental budget that would have specifically directed funds. The estimated cost of expansion was one of the major sticking points. The nonpartisan Office of Fiscal and Program Review estimated that it would cost $45 million in the first year, but the LePage administration argued that it would cost much more and that it would only increase in future years.

The expansion will open up the program to Mainers who earn 138 percent of the federal poverty level, $16,753 per year for an individual or $34,638 for a family of four.

Kilbreth said Thursday in court that there already are enough funds in the state’s Medicaid account to get through the current budget biennium, which ends in June 2019. He also said there is more than $140 million in unallocated funds that the state could draw from at any time.

But Murphy’s decision likely won’t hinge on whether funds are available, only whether the state has violated the law by failing to submit its state plan amendment.

She said she would rule soon but didn’t specify when.


There is also a chance the decision could be appealed.

Even if Murphy rules that the state must submit a plan, if funding isn’t ironed out by the July 2 deadline, additional legal challenges could follow, advocates have said.

Eric Russell can be contacted at 791-6344 or at:

Twitter: PPHEricRussell

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