An advocacy group for low-income Mainers that’s suing the LePage administration went to court this week to try to erase any reference to Gov. Paul LePage’s request to federal officials to reject Medicaid expansion.

In early September, LePage filed a form with Medicaid – called a State Plan Amendment – that’s typically a routine document states use when applying for Medicaid expansion.

But LePage took the unusual step of simultaneously filing the amendment and asking the federal government to reject it, which would halt Medicaid expansion.

The court filing with the Maine Business and Consumer Court on Thursday is the latest step in a monthslong legal fight over implementing Medicaid expansion, which would make about 70,000 low-income Mainers eligible for free health insurance.

LePage, a steadfast opponent of Medicaid expansion, was forced by the Maine Supreme Judicial Court to file a State Plan Amendment with Medicaid that would jump-start expansion.

Maine voters approved Medicaid expansion by 59 to 41 percent in November 2017, but LePage has refused to implement it, citing budgetary concerns.

Maine Equal Justice Partners this week filed a motion in business court that, if successful, would bring in a third party, called a receiver, to amend the State Plan Amendment. The receiver would remove LePage’s Aug. 31 letter asking the court to reject the expansion, as well as portions of the Sept. 4 form itself that also ask the U.S. Centers for Medicare & Medicaid Services to deny expansion.

“This was not submitted in good faith to ensure (Medicaid) eligibility as was required by the court,” said Robyn Merrill, executive director of Maine Equal Justice Partners.

Julie Rabinowitz, a LePage spokeswoman, said “the governor will respond in court at the appropriate time, but believes this filing lacks merit.”

LePage, in his letter asking Medicaid to reject the State Plan Amendment, argued that the state had not set aside money for the expansion. LePage this summer vetoed $60 million in expansion funds approved by lawmakers, with the governor claiming they were one-time budgetary gimmicks.

Maine Equal Justice Partners has disputed LePage’s budget arguments, saying the state has enough money to start the expansion, and that it’s not the federal government’s role to step into state budget disputes.

“The inclusion of unrequested, unprecedented and highly disputed claims about the state’s financial circumstances has no place on a form that merely seeks to alert the federal government to what its financial obligations will be,” according to the motion. “Its inclusion can only be seen as an effort to achieve what the governor requested – denial of the addition of the expansion group, in violation of this Court’s order and the will of the people.”

The Maine Supreme Judicial Court in August ordered the LePage administration to file the State Plan Amendment.

Rabinowitz, in a statement to the Press Herald, wrote that the “motion ignores the fact that the governor’s action complied with the terms of the order and is entirely consistent with the concurring opinion written by the Chief Justice of the Maine Supreme Court.” Rabinowitz was referring to Chief Justice Leigh Saufley, who wrote a concurring opinion that agreed LePage must file a State Plan Amendment but also said that the plan, for budgetary reasons, has “no reasonable likelihood of meeting the approval of the administrators of the federal Medicaid program.”

Filing the amendment while simultaneously arguing that the federal government reject the application is also in contempt of court, Maine Equal Justice Partners argued in its filing.

But rather than hold the LePage administration in contempt, attorneys for Maine Equal Justice wrote that a better option would be for the court to appoint a receiver to edit the State Plan Amendment.

Medicaid officials couldn’t be reached for comment by the Press Herald this week.

Maine Equal Justice Partners also sent a letter to Medicaid officials earlier this week urging them to ignore LePage’s request to deny the State Plan Amendment.

Medicaid is a federal program operated by the states and funded by a mixture of state and federal dollars. Medicaid expansion is a key component of the Affordable Care Act, but a 2012 U.S. Supreme Court decision said that states could choose to opt out of expansion. Thirty-four states, including Maine, have approved Medicaid expansion.

Under Medicaid expansion, the federal government pays 90 percent of the costs of expansion. Mainers earning up to 138 percent of the federal poverty level, or $34,638 for a family of three and $16,753 for a single person, would be eligible. About 273,000 Maine residents are already covered by Medicaid.

The court filing also argues that the effective date of the expansion should be July 2 instead of the State Plan Amendment’s filing of Sept. 4.

A pending court case in Superior Court will decide, among many issues, whether Maine residents should be entitled to Medicaid retroactive to July 2, when Maine Equal Justice argues the law should have gone into effect.

Some Maine residents – it’s not clear how many but possibly hundreds – applied for Medicaid under expansion eligibility shortly after July 2. The Maine Department of Health and Human Services sent them denial letters.

Joe Lawlor can be contacted at 791-6376 or at:

[email protected]

Twitter: joelawlorph

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