AUGUSTA — A day after the Maine House endorsed it, the Senate without discussion Tuesday voted down House Speaker Rachel Talbot Ross’ bill to allow income-eligible noncitizens to receive health coverage under the state’s Medicaid program.

The House of Representatives voted 78-61 Monday in favor of the bill, L.D. 199, which was supported by the majority of the Health and Human Services Committee but has faced opposition from Republicans, who criticized the proposal’s $17 million price tag.

Republicans have said that passing the bill would be too much of a burden for Maine taxpayers because it would cover a group of people ineligible for federal Medicaid funding, leaving the state and its taxpayers to pick up the costs. They say it would especially burden Maine seniors.

But House Democrats argued the bill was a matter of fairness because asylum seekers are allowed to work and pay taxes for months and sometimes years while waiting for their applications to be approved by the federal government, but are unable to receive Medicaid benefits.

The legislative votes come as a record number of asylum seekers have arrived in Portland and surrounding communities, straining the emergency shelter system as housing prices and a lack of available housing make it difficult for people to find permanent homes.

Low-income noncitizens are currently eligible for only a limited scope of emergency health services. They do not have access to routine or preventive care. The costs of uncompensated care are usually passed on to other patients with private or public health insurance.


The Senate vote is almost certain to kill the bill. The House will get another chance to change its mind and kill the bill or stand its ground and hope the Senate will back down. If neither chamber changes its vote, the bill would die between the House and Senate.

Even if the House stands by the bill and the Senate reverses course, the bill still would need to receive funding approval by legislative leaders, who also are looking to free up funding for big-ticket priorities such as paid family and medical leave and increasing access to child care.

The bill was mostly supported during a public hearing in March, with dozens of immigrants and advocates discussing the impacts of not being able to access routine health care, including medications for chronic illnesses.

Medicaid is paid for with a combination of federal and state funds. Each state administers its own Medicaid program, which is called MaineCare in Maine. The state spends about $800 million on MaineCare each year.

Forty states cover noncitizens who are lawfully residing children or pregnant women, or provide prenatal care regardless of immigration status, or use state funds to cover certain immigrants, according to the National Immigration Law Center. But it’s unclear how many states cover all noncitizens who would otherwise qualify for Medicaid.

Maine provided public health benefits to noncitizens up until 2011, when former Republican Gov. Paul LePage eliminated their eligibility. Last session, lawmakers returned health insurance coverage to noncitizen pregnant mothers and children under the age of 21.

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