January 5

Medicaid expansion, welfare reform, budget top State House agenda

Those issues, rubbing shoulders with the budget, will dominate the Maine Legislature's second session, set to begin Wednesday.

By Steve Mistler smistler@pressherald.com
Staff Writer

Quick and dirty.

click image to enlarge

Nik Rende, a senior programmer/analyst for the Maine Legislature, fixes a microphone in the Senate Chamber of the State House in Augusta. He and other workers were preparing for the new session that opens Wednesday morning.

Joe Phelan/Kennebec Journal

That’s typically how second sessions of the Legislature go, and the one that begins Wednesday should be no different. Lawmakers will tackle a number of issues that could have far-reaching impacts on Maine residents, including the expansion of Medicaid for about 60,000 low-income people, welfare reform and a supplemental state budget that could increase the burden on property taxpayers.

But election-year politics and rhetoric will accompany and shape many, if not all, of the issues.

“The bad news is that the session takes place during an election year, which means things tend to get very partisan,” said Sen. Roger Katz, the assistant Republican leader from Augusta. “The good news is that it takes place during an election year, which means lawmakers tend to want to get things done quickly so they can go home and concentrate on campaigning.”

At least two of the hottest topics – Medicaid expansion and welfare – may well become part of those campaigns.

MEDICAID EXPANSION

Democrats, who won the majority of the Legislature in hotly contested races in 2012, are expected to try to retain that advantage this fall championing the expansion of Medicaid, the publicly funded health insurance program for the poor, elderly and disabled that the state calls MaineCare. Two efforts to pass Medicaid expansion for Mainers who make less than 138 percent of the federal poverty level last year failed, and the push in 2014 will be just as difficult.

“We have to find a way to pass Medicaid expansion,” said Sen. Anne Haskell, the assistant Democratic leader from Portland. “That is the priority this session.”

Gov. Paul LePage and most Republican lawmakers have opposed expansion, arguing that Maine’s previous experience with expanding the program has hamstrung state budgets. They contend that the latest federal proposal is accompanied by hidden costs, and they question promises that the federal government will fully fund expansion for three years, before gradually drawing down to a 90 percent reimbursement rate.

Health and Human Services Commissioner Mary Mayhew has said the state’s $2.4 billion Medicaid program, which takes up most of the agency’s $3.4 billion budget, is unsustainable. She has repeatedly said that even if the federal dollars arrived as promised, the state would still pay $150 million a year to manage the expansion population.

Polarization over Medicaid expansion can be attributed to its connection to the Affordable Care Act, the federal health care law that encountered a near disastrous rollout in 2013. Republicans locally and nationally have feverishly opposed the law, also known as Obamacare, and already congressional candidates are positioning their campaigns by talking up its bumpy launch. In Maine, State House Republicans have linked President Obama’s now-infamous promise, “If you like your health care plan, you can keep it,” with Medicaid expansion’s promise of federal funding.

More recently, Republicans used findings from a Harvard study evaluating impacts of Medicaid during a long-term experiment in Oregon. The study rebutted a key argument by expansion proponents that access to health care reduces emergency room visits. The Oregon study showed a net increase.

Katz, the Augusta Republican leader, last year authored a Medicaid expansion amendment that fell a few votes short of overriding the governor’s veto. He said there were compelling arguments to proceed with expansion, but Republicans open to the idea want it to include an evaluation of the program, its health benefits and some “skin in the game” for recipients. He noted that other Republican governors have been able to craft expansion proposals to meet those goals, but he was unsure if it could happen in Maine.

Instead, the fate of Medicaid expansion in Maine may well be determined by how it helps or hurts a lawmaker’s chance for re-election. Recently the Maine People’s Resource Center, a polling organization affiliated with the Maine People’s Alliance, a liberal activist group supporting the health care law, released a poll showing broad support for Medicaid expansion in legislative swing districts.

(Continued on page 2)

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