February 2, 2013

New federal poverty guidelines could preserve MaineCare recipients

State has plans to trim or cut services to more than 20,000 recipients

By Kelley Bouchard kbouchard@pressherald.com
Staff Writer

New federal poverty guidelines could reduce the number of people who will be cut from MaineCare, the state's Medicaid program, as a result of federal funding waivers granted recently to the LePage administration.


The U.S. Department of Health and Human Services issues new poverty guidelines each year to account for increases in the Consumer Price Index. Government and other agencies use the guidelines to determine eligibility for various public assistance programs.

Family members 2012 2013

1         11,170     11,490

2         15,130     15,510

3         19,090     19,530

4         23,050     23,550

5         27,010     27,570

6         30,970     31,590

7         34,930     35,610

8         38,890     39,630

Source: U.S. Department of Health and Human Services

The guidelines, issued by the U.S. Department of Health and Human Services on Jan. 24, raised the poverty level 2.9 percent for a single person, from $11,170 in annual income to $11,490, and 2.2 percent for a family of four, from $23,050 to $23,550.

"It means more people could be eligible (for MaineCare) and fewer people may be cut as a result," said Mitchell Stein, policy director with Consumers for Affordable Health Care.

It's still uncertain, however, how many Mainers will retain MaineCare coverage because of the higher poverty guidelines and how it will affect Gov. Paul LePage's effort to balance the state budget.

"Since this change was just released, we are analyzing the impact in terms of those who may now be eligible due to the new guidelines. That analysis is not yet complete," said John Martins, spokesman for the Maine Department of Health and Human Services.

On Jan. 7, federal officials notified Health and Human Services Commissioner Mary Mayhew that Maine could go ahead with two of four requested spending reductions in MaineCare.

The reductions, some of which take effect March 1, were expected to eliminate or reduce Medicaid benefits for more than 20,000 low-income parents, seniors and disabled Mainers. The estimated $4.5 million saved in the last four months of the fiscal year would address just a fraction of a $90 million MaineCare revenue shortfall that came to light in November.

One waiver allowed Maine to eliminate coverage for 12,592 parents who earn 133 percent to 200 percent of the federal poverty level, which is $31,322 to $47,100 per year for a family of four.

Another waiver allowed the state to deny or reduce Medicaid health care and prescription drug coverage for 8,250 elderly and disabled adults in the Medicare Savings Plan and Drugs for the Elderly program. About 2,600 of those people were expected to lose all coverage.

The DHHS sent letters late last week and early this week, letting MaineCare recipients know whether their coverage would be affected.

People whose income is near the qualifying poverty levels, who got letters saying their coverage would be eliminated or reduced, can expect a second letter from the DHHS this month telling them whether their coverage will be sustained.

"If it turns out that somebody's eligible now, they'll get a letter telling them so," said Jack Comart, litigation director for the advocacy group Maine Equal Justice Partners.


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