May 23, 2013

Maine Medicaid bill meets its fate: passed, vetoed

Minutes after Democrats' symbolic victory, LePage wipes it out and calls for a different bill to repay Maine's hospital debt.

By Steve Mistler
State House Bureau

AUGUSTA — Democrats in the Legislature knew that their signature policy achievement – a combination bill to expand public health insurance for the poor and pay off Maine's $186 million debt to its hospitals – was likely temporary.

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Moments after it was passed, Gov. Paul LePage reads his veto message of L.D. 1546, "An Act To Strengthen Maine's Hospitals, Increase Access to Health Care and Provide for a New Spirits Contract," in the Hall of Flags on Thursday in the State House in Augusta.

Staff photo by Joe Phelan

Gov. Paul LePage has vetoed a bill that included both Medicaid expansion and the repayment of hospital debt.

On Thursday, Gov. Paul LePage made it so.

Within minutes of the Senate's final passage of L.D. 1546, LePage and Republican lawmakers gathered in the State House Hall of Flags, where Democrats were preparing to hold their celebratory news conference. The governor, sitting at a desk beneath a bank of television cameras, quickly signed his veto message.

It was only a draft veto; the official bill hasn't yet hit his desk. But it was a symbolic end to what appears to be only a symbolic victory for Democrats, who used a high-risk strategy to get what they hoped would be a high-reward outcome, the expansion of Medicaid.

Shortly thereafter, Democrats gathered on the Hall of Flag's steps. They rolled out the props. A map showing the number of Mainers who would gain health insurance through Medicaid expansion. An oversized check made out to Maine's hospitals, now symbolically voided with LePage's symbolic veto.

Senate President Justin Alfond, D-Portland, and House Speaker Mark Eves, D-North Berwick, proceeded with the news conference, knowing the governor had pre-empted their event.

Eves, delivering his most forceful remarks as speaker, blasted LePage.

"Gov. LePage had an opportunity to prove to Maine people that he could compromise," Eves said. "He failed. He had an opportunity to put politics aside. He failed. Gov. LePage has failed to pay his bills. He failed to provide health care to people whose lives are on the line."

Eves urged Republicans to override the governor's veto. That appears unlikely.

Since taking office in 2011, LePage has vetoed about 20 bills passed by the Legislature. Only two vetoes have been overridden.

And Republicans have unilaterally rejected L.D. 1546 during floor votes, calling it reckless and futile for Democrats to link Medicaid expansion with a bipartisan proposal to pay the hospital debt.

Democrats believed that L.D. 1546 was their best and only chance to expand Medicaid to an estimated 60,000 Mainers. Using their majorities in the House and Senate, they took LePage's signature policy goal -- paying back the hospitals -- and tied it to Medicaid expansion. That distinguished Maine from the other states in the Medicaid debate, the latest front in the battle over the federal Affordable Care Act.

The legislative vehicle in Maine was different, but the debate was the same as everywhere else. Democrats said expansion will cover more people, improve health outcomes and reduce health care costs. Republicans said Medicaid expansion is risky, far from free and a costly way to deliver health insurance.

The floor debates over the bill have been the most contentious and passionate of this legislative session.

It was personal for some Democrats.

During the first Senate floor debate, Sen. Troy Jackson, D-Allagash, talked about two friends in his district who died from heart failure after being diagnosed initially with acid reflux. Neither had health insurance.

Jackson had a similar diagnosis, and found that he had a heart condition. He now has a pacemaker -- and the guilt of having health insurance because he's a legislator.

"It's ... embarrassment that I had health insurance and they didn't," Jackson said. "It's embarrassment that I'm alive and they didn't have that opportunity."

Sen. Roger Katz, R-Augusta, acknowledged that the cause is heartfelt for some Democrats.

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