April 17, 2024
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As Maine Medicaid expansion stalls, hospitals and enrollees are left in limbo

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Maine’s Medicaid-eligible residents, which make up more than 70,000 people, were set to enroll on July 2 as part of the expansion plan approved by nearly 59 percent of voters last November.

But after a month of battles between advocacy groups and stonewalling efforts by Gov. Paul LePage’s administration, the enrollment date has passed and hospitals are left waiting for an influx of patients and staffing needs that may not come anytime soon.

“A hospital representative I work with said they all have their fingers crossed that [the expansion] gets approved and it all goes smoothly, but she agreed it is a mess currently,” said Larry Jenkins, a sales team member for staffing agency LiquidAgents Healthcare. “There are no plans for additional staff at this time.”

For clarity, here’s a timeline of where Maine’s Medicaid expansion plan stands:

  • November 2017: Maine voters approve Medicaid expansion under provisions outlined in the Affordable Care Act, making Maine the first state to approve expansion by referendum. The Maine Department of Health and Human Services is required to file a plan by April 3, 2018
  • April 3, 2018: No plan is filed by Maine DHHS. LePage said he would not move forward with a plan until adequate funding is approved by the legislature to support expansion efforts.
  • April 30, 2018: Advocacy group Maine Equal Justice Partners sue Maine DHHS to force the administration to submit a plan, citing a $130 million surplus fund that could be used to fund the expansion for 2019.
  • June 4, 2018: Superior Court Justice Michaela Murphy rules in favor of Maine Equal Justice Partners, citing a “complete failure to act” by Maine DHHS in missing the April 3 deadline. They are ordered to submit a plan by June 11.
  • June 7, 2018: LePage’s administration files an appeal for the decision, and requests to not file a plan by June 11 while the appeal is considered.
  • June 18, 2018: Justice Murphy denies the appeal and orders DHHS again to file a plan with the federal government. Gov. LePage’s legal team appeals the order to the Maine Supreme Judicial Court to delay the deadline while the original appeal is considered. Arguments are scheduled for July 18.
  • June 29, 2018: Gov. LePage vetos a potential expansion funding bill. Lawmakers must decide to override or uphold the veto on July 9.
  • July 2, 2018: Maine Equal Justice Partners encourage eligible residents to apply for Medicaid anyways despite ongoing litigation.
  • July 9, 2018: Conservative legislators uphold the veto in an 85-58 House vote. LePage and House Republicans criticize “one-time” funding sources included in the plan, saying Maine needs a long-term funding plan.

Monday’s vote on the veto of Maine’s Medicaid expansion funding bill marks the sixth time LePage has stopped expansion legislation through the use of veto during his two terms of office.

The final verdict on Maine’s Medicaid expansion efforts may set the precedent for lawmakers in Idaho, Nebraska and Utah. Advocacy groups submitted similar ballot initiatives after successful petitions to let voters decide the fate of Medicaid in their states this November.

Utah’s ballot initiative passed state scrutiny and was added to the fall ballot. Secretaries of state in Nebraska and Idaho are reviewing petition signatures to confirm they represent a specific percentage of voters in each state.

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