AUGUSTA — The LePage administration went back to court Monday in its bid to hold up the voter-approved Medicaid expansion until funding is in place, filing a second appeal of a lower court ruling requiring the state to move forward with the implementation.

LePage’s legal team had appealed the lower court ruling to the Maine Supreme Judicial Court and on Monday it went back before the state’s highest court to ask it to delay the deadline it was given to file a formal expansion plan while the court considers its appeal of the underlying issue. The administration’s action Monday followed an order Friday in which a Kennebec County Superior Court justice denied the administration’s request to stay, or delay, the deadline to comply with the voter referendum.

That order also said the executive branch’s failure to follow the people’s will could engender disrespect for laws. The deadline was June 11, and it’s not clear how quickly the administration would have to comply if the high court denies its request for a stay.

Nearly 60 percent of Maine voters supported a referendum in November to expand Medicaid health insurance to more than 70,000 adults with incomes at or below 138 percent of the federal poverty level – $16,753 for an individual and $34,638 for a family of four.

LePage has said he won’t follow the expansion law until the Legislature approves a way to pay for the state’s share of expansion costs. Estimates of the state’s expansion costs have varied widely, but the nonpartisan Office of Fiscal and Program Review has projected they would be about $45 million in the first year. The administration says it will cost as much as $60 million in the first year and as much as $100 million annually in future years. Advocates argue the state could move forward with existing funds.

LePage’s refusal to meet deadlines for the voter-approved expansion prompted a lawsuit and a ruling by Kennebec County Superior Court Justice Michaela Murphy that the administration must submit a formal expansion plan to the federal Centers for Medicaid and Medicare Services. The administration appealed Murphy’s ruling to the Maine Supreme Judicial Court, which has yet to rule.


Both Department of Health and Human Services Commissioner Ricker Hamilton and attorneys for Maine Equal Justice Partners, which brought the original lawsuit against LePage, have urged the high court to expedite its hearing on the administration’s appeal.

In Friday’s ruling denying the administration additional time, Murphy said LePage’s attorneys had not established a likelihood of success on the merits of their appeal and that public interest would be adversely impacted were the stay allowed. She also wrote that the harm to those who would become eligible to receive Medicaid benefits outweighed any potential harm to the state.

“The executive branch’s refusal to act and follow the will of the people … has the potential to engender disrespect for duly enacted laws,” Murphy wrote.

The LePage administration argued in Monday’s appeal that the state shouldn’t be forced to file a federal application without first knowing whether it must move forward.

“This case raises tremendously consequential and far-reaching issues regarding the separation of powers and Maine’s long-term fiscal health,” Patrick Strawbridge, the attorney hired by LePage to represent the state in the expansion case, wrote in his appeal to the law court. “The Superior Court’s order required the (Health and Human Services) commissioner to make a binding commitment to the federal government to expand the state’s Medicaid program even though none of the necessary funding or staffing to effectuate the expansion has been appropriated by the Legislature.”

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


LePage and his allies have grudgingly acknowledged 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 is required to contribute its own funds. Thirty-one states already have expanded Medicaid under the provisions of the Affordable Care Act.

Meanwhile, the Legislature, which adjourned in May after lawmakers were unable to reach agreement on, among other things, a funding mechanism for the expansion, was expected to reconvene in a special session Tuesday.

It remained unclear Monday whether a partial funding bill, which would appropriate about $3 million for covering the state’s administrative costs associated with expansion, would be in the mix.

Democratic lawmakers also have argued that the state has the funding available in its surplus revenues to launch the expansion plan, which would take several years to reach the anticipated state costs. Under the expansion, the state’s share of expansion would be matched with federal funds at about a 10:1 ratio, meaning the state would receive about $500 million a year for each $50 million it spent on an expanded Medicaid program.

Scott Thistle can be contacted at 713-6720 or at:

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