May 17, 2013

LePage: MaineCare broke in three weeks without new budget

Democrats counterattack, claim 'mismanagement' of state agency; summon Commissioner Mary Mayhew to emergency meeting Sunday

AUGUSTA — Gov. Paul LePage blasted legislative Democrats for inaction in a Friday letter, saying the Maine Department of Health and Human Services will run out of money to pay Medicaid providers in three weeks without action on a new state budget.

click image to enlarge

Department of Health and Human Services Commissioner Mary Mayhew, left, and Gov. Paul LePage answer questions during a news conference on Thursday in the State House in Augusta.

Staff photo by Joe Phelan

That statement, however, led Democrats to accuse the LePage administration of "mismanagement" of the department after its most recent cost overrun in MaineCare, the state's version of Medicaid, the federal health care program for the poor.

Jodi Quintero, a spokeswoman for House Speaker Mark Eves, D-North Berwick, said Democrats have beckoned DHHS Commissioner Mary Mayhew to an emergency meeting at 1:30 p.m. Sunday before the Legislature's budget-writing committee to answer "tough questions" about the department's precarious fiscal standing.

In the letter to Eves and Senate President Justin Alfond, D-Portland, LePage said "Democratic leadership is engaging in Washington-style politics" — putting off action on the budget — while "a crisis is looming that will affect our most needy citizens."

An accompanying letter from Mayhew to LePage says "beginning the week of June 10, our ability to pay the providers to who help us deliver vital services to our members is in serious jeopardy." She said money must be allocated to the department by May 28 to pay providers.

LePage has foreshadowed that notion before, but Quintero said the announcement of an impending cost overrun concerns Democratic leaders "who continue to have concerns about the mismanagement of the department," she said.

"The timing and intent of this letter is questionable," Eves said in a statement late Friday. "It seems more geared toward fear mongering than problem solving."

In a package of changes to the state's next two-year budget proposed earlier this month, it was revealed that DHHS will need another $35 million for the current fiscal year, which ends in June, largely to meet its MaineCare obligations, David Heidrich, a spokesman LePage's budget department, has told MaineToday Media.

Under the LePage administration's plan to close that gap, most of the $43 million in higher-than-expected tax revenue that was expected to be available for the next budget would be used to this year's MaineCare gap.

Chronic cost overruns have long plagued MaineCare. For example, DHHS, announced in November it was projecting a $100 million shortfall, the main reason for a supplemental budget passed earlier this year.

That budget passed without LePage's signature, because he said some of his funding requests for DHHS were ignored. He warned then that the department could require additional funding before the year is out.

"Effectively, they did not balance the budget back then," said Adrienne Bennett, a spokeswoman for LePage.

The Democrats could pass LePage's proposed two-year budget with the change package, but a number of big-ticket items in the budget are unpalatable to most legislators — especially a more-than-$200 million zeroing out of revenue sharing to cities and towns.

There is no full alternative yet to that budget, though Quintero said the Appropriations Committee has agreed on most of the individual items in the budget already.

However, the LePage administration could come back to the Legislature with another supplemental budget to close the MaineCare gap.

It hasn't done so, Bennett said, because "we're believing that they are going to take action in good faith to resolve this before then." She wouldn't give a time frame for when the administration would do so if the Legislature didn't act, but she said it was a backup option the administration is considering.

In the letter, LePage continued to press Democrats to pass his plan to pay Maine's $186 million share of hospital debt to hospitals, which is linked to borrowing money using revenue from a renegotiated liquor contract.

In recent weeks, Democrats have linked expansion of Medicaid under the federal Affordable Care Act to that proposal — angering LePage, as he has blamed cost overruns on Maine's earlier expansion of Medicaid, a program he considers too large and generous.

He and Republicans say the repayment and expansion issues are separate, while Democrats say expanding the program would ensure that thousands more Mainers would receive health care and increase patient volume for hospitals.

An analysis by the Kaiser Family Foundation has projected that Maine would save $690 million in the next 10 years if it accepts federal dollars under the Affordable Care Act to provide care to about 55,000 Mainers.

The federal government has said it would fund expansion fully from 2014 to 2016, after which the reimbursement rate would decline gradually to 90 percent, with the state paying the rest. Republican critics say trusting continued reimbursement is unwise because of ongoing federal deficit problems.

"It is morally and economically the right thing to do to address the costs of health care for our hospitals and our people," Alfond said in a Wednesday statement. "People's lives are on the line. Now is the time to do this."

Michael Shepherd — 370-7652
mshepherd@mainetoday.com
Twitter: @mikeshepherdme

 

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