August 16, 2012

Maine Democrats write to HHS Secretary Sebelius about LePage's Medicaid plans

By John Richardson jrichardson@pressherald.com
Staff Writer

AUGUSTA -- Top Democratic state lawmakers sent a letter to the Obama administration Wednesday opposing Gov. Paul LePage's plan to cut Medicaid benefits for about 27,000 Mainers.

Gov. Paul LePage

Kathleen Sebelius
click image to enlarge

U.S. Health and Human Services Secretary Kathleen Sebelius

AP photo

Sen. Dawn Hill, D-Cape Neddick, and Rep. Peggy Rotundo, D-Lewiston, wrote to U.S. Health and Human Services Secretary Kathleen Sebelius disputing LePage's arguments that the cuts are needed because of a state budget crisis. They also argue in the letter that the Affordable Care Act continues to forbid such cuts without a special waiver despite LePage's argument otherwise.

"It is important to note that there is no budget deficit. In fact, the state ended FY 2012 with a $20 million budget surplus. In April 2012, the Revenue Forecasting Committee re-projected state revenues upward by $50 million," the letter says.

Hill and Rotundo are the ranking Democrats on the state's budget writing Appropriations Committee and say in the letter they speak for all the committee's Democrats.

While the Legislature did have to cut spending keep the budget balanced, Hill and Rotundo said lawmakers had other options besides ending Medicaid coverage for 19- and 20-year-olds and low-income parents. They argue in the letter that the budget shortfall was a manufactured crisis, saying the Republican-led Legislature approved tax cuts that take effect starting next year and will eventually reduce revenues by $700 million a year.

Maine's Medicaid program, known as MaineCare, is mostly paid for with federal money and must comply with federal rules. Maine's Legislature approved eligibility changes to eliminate coverage for about 27,000 people, but those changes still must be approved by the federal agency that oversees Medicaid.

LePage requested the approval in a so-called state plan amendment application sent to Sebelius Aug. 1. He said Maine is dealing with a budget deficit and needs to cut benefits. He also argued that the recent U.S. Supreme Court decision gives states the flexibility to determine their own eligibility standards.

The Supreme Court ruled that states do not have to expand Medicaid eligibility in 2014 as federal law required, but it did not specifically rule on the issue of whether states can roll back existing eligibility standards without getting a special waiver.

The DHHS Centers for Medicare and Medicaid Services has not yet replied to LePage's requests, although an official noted early this month that some of the eligibility changes did not appear to be consistent with federal law. Democrats also have pointed to a recent opinion from the Congressional Research Service, which works as a think tank for Congress, saying the U.S. Supreme Court decision did not change the requirement that states need special waivers for such changes.

Maine's Department of Health and Human Services, meanwhile, continues to move forward with plans to implement the cuts on Oct. 1.

It published legal ads in the Portland Press Herald, Kennebec Journal and Morning Sentinel Wednesday with formal notice of several MaineCare rule changes, including tighter eligibility standards that would cut off benefits to 19- and 20-year-olds and some low-income parents. The notices say the department will hold a public hearing on the formal rule changes at 9 a.m. Sept. 4 at 19 Union Street in Augusta., and that written comments will be accepted through Sept. 14.

However, the notice on planned eligibility changes also says they may not happen. "If the department does not receive federal approval prior to October 1, 2012, the department will abandon this rulemaking and the commissioner will not adopt these rules," it says.

 

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