AUGUSTA — The federal government has approved Maine’s request to establish work and premium payment requirements for some of its 258,000 Medicaid beneficiaries.

Gov. Paul LePage announced the change Friday, saying it will help push those who can work to find jobs while protecting benefits for the elderly, the disabled and children.

“Under my administration, we have worked to lift Mainers out of poverty by prioritizing work within our welfare programs,” LePage said in a prepared statement. “With the approval of the (application), we will be able to replicate that success in our Medicaid program.”

The announcement was immediately attacked by advocates for low-income Mainers, who contend the requirements would do more harm than good.

Scott Ogden, a spokesman for Maine Gov.-elect Janet Mills, said the Democrat has not reviewed the new waiver requirements for Medicaid, but would do so once she takes office. Medicaid operates in Maine under the name MaineCare.

Under Maine’s waiver request, which was approved by the federal Centers for Medicare and Medicaid Services, adults who receive MaineCare services and are able to participate in “community engagement activities or work” will be required to do so. The waiver also would allow the state to collect monthly premiums from adults who have the ability to earn income.


LePage said the changes are meant to build on similar reforms that were applied to other benefit programs for poor families and children.

“For all of our public assistance programs, our primary goal is to help people,” LePage said. “We can help people by supporting and encouraging them to stand on their own – allowing them to take charge of their financial independence. This approval is a big step forward for our state, as it provides us the opportunity to continue expanding our available workforce and allows us to focus our resources on those individuals who need it most.”

But advocates for the poor and disabled in Maine said the shift would only take health coverage away from people who are already struggling to get by.

Kathy Kilrain del Rio, a policy analyst with Maine Equal Justice Partners, said the shift will hurt and not help Maine’s poorest citizens.

“When people are struggling to make ends meet, imposing additional costs to access health care will result in fewer people getting the care they need,” Kilrain del Rio said in a prepared statement. “In the long run, that will harm thousands of Mainers and it will also result in economic costs for our state.”

Centers for Medicare and Medicaid Services Administrator Seema Verma touted the waiver approval, saying states like Maine were making strides to connect physical and financial health.


“Maine marks the seventh community engagement demonstration we have approved since announcing this important opportunity earlier this year,” Verma said in a prepared statement. “I’m proud that CMS has responded so effectively to the strong interest from states interested in helping connect working-age adult Medicaid beneficiaries with opportunities to improve their health and financial independence through work and community engagement.”

President Trump’s administration opened the door to work requirements for Medicaid in January, and LePage first filed the waiver application in the spring of 2017. Under the waiver, MaineCare beneficiaries can be asked to pay between $10 and $40 a month in premium charges to the state. The requirements would not apply to elderly or disabled people.

Ogden, Mills’ spokesman, did not indicate whether the Democrat would support the change.

“As a general matter, the Gov.-elect supports programs that offer apprenticeships, vocational education, computer sciences and other training initiatives to put people to work to fill available jobs, preferably by incentives instead of by bureaucratic mandates,” Ogden said. “Making sure people are healthy, of course, is a first step in making them eligible for work.”

Health advocacy groups, including the Eastern Division of the American Lung Association, urged Mills to suspend implementation of the new waiver.

“The American Lung Association in Maine believes everyone should have access to quality and affordable healthcare coverage. Maine’s Section 1115 Work Requirement Waiver does not advance that goal,” said Lance Boucher, the senior director of state advocacy for the association in Maine. ” We are very disappointed to see it approved today by the CMS. Those who fail to navigate these new burdensome requirements could have serious – even life or death – consequences.”


Boucher noted a similar waiver program in Arkansas saw some 16,000 people lose health care coverage.

“These policies do not further the goals of the Medicaid program or help low-income Mainers get health insurance,” Boucher said.

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

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