February 10

Democrats plan bill to kill embattled welfare study contract

They say the first Alexander report was a skewed analysis the state can’t afford, but the DHHS chief insists it was accurate and useful.

By Steve Mistler smistler@pressherald.com
Staff Writer

(Continued from page 1)

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Gary Alexander, founder of the Alexander Group, gives his analysis recently of a report his group developed regarding the cost of expanding MaineCare at the Department of Health and Human Services.

Gregory Rec / Staff Photographer

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The Alexander report was touted initially by Republican lawmakers as a reason to oppose Medicaid expansion, a key policy battle in this session. However, Republican support for the report has been muted since its findings were questioned by outside analysts.

In January, Kathy Gifford, a Medicaid analyst for Indianapolis-based Health Management Associates, said the report has several shortcomings, including a miscalculation that could significantly overstate the cost of expansion. Gifford reviewed the study for AARP, which favors Medicaid expansion.

Gifford said the Alexander Group apparently used a lower federal reimbursement rate for its calculations than it cited in the text of the report, effectively inflating Maine’s share of the cost by $575 million.

Gifford also noted that, unlike independent analyses of Medicaid expansion in other states, Alexander’s report omitted any savings that might come from expanding the program. Savings are generated largely by migration out of programs in which the state pays most of the cost, and into Medicaid, in which various federal reimbursement rates are higher.

Other states have used such analyses to determine whether they want to expand their Medicaid programs.


Under the contract, the Alexander Group was given several target dates to deliver specific elements of its analysis. The group missed its Dec. 1 target date for the Medicaid expansion study.

The report was delivered Dec. 16, and the LePage administration didn’t release it until Jan. 10, even though the contract notes that all documents in the state’s possession are subject to the state Freedom of Access Act.

In January, Attorney General Janet Mills, a Democrat, told LePage to release the report in response to multiple media requests, including from the Portland Press Herald. LePage responded that if Mills wanted him to release the report, she should sue him.

The Alexander Group was also scheduled to deliver a “data-driven analysis” of the state’s welfare system, as well as a plan to redesign the Medicaid system, on Dec. 20. A spokesman for the DHHS said Jan. 14 that the department was giving Alexander more time to complete the reports and had not set a deadline.

The spokesman, John Martins, said 40 percent of the payment to the Alexander Group would be withheld until the required work has been completed.

Steve Mistler can be contacted at 791-6345 or at:


Twitter: @stevemistler

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