AUGUSTA — Gov. Paul LePage’s proposal to drop about 14,000 low-income parents from Medicaid health insurance is the latest sticking point in state budget negotiations.

Lawmakers again worked into the night Tuesday to try to close a shortfall at the Department of Health and Human Services. As day turned to night, legislators on the Appropriations Committee expressed optimism that they were nearing final votes on a $142 million budget to fill an immediate hole.

But philosophical differences between the parties meant no easy resolution. Republicans say the state must reduce the number of people receiving MaineCare benefits to create a more affordable system, while Democrats say it’s wrong — and ultimately more expensive — to drop health insurance coverage for thousands who need state assistance.

Over the next 16 months, DHHS faces a $221 million shortfall, which is why LePage proposed a series of sweeping changes that would mean the elimination of MaineCare for 65,000 people. After delaying action on about $80 million of the most controversial cuts, the committee is now working to come to agreement on $142 million to fill the gap before the department runs out of money in April.

Part of the proposal under consideration this week is tighter income guidelines for a program that provides health insurance for parents of children who are on MaineCare, Maine’s Medicaid program. LePage’s proposal would save $9.3 million and drop 14,000 parents from MaineCare. It’s one of the structural changes he would like to see as part of his goal to reduce overall Medicaid enrollment.

In another area, Democrats and Republicans on the Appropriations Committee tentatively agreed to modify LePage’s proposal that called for eliminating medical coverage for childless adults between the ages of 21 and 64. While LePage proposed to drop 18,600 from MaineCare, some committee members are supporting a proposal that would maintain coverage for those currently enrolled, but save money by continuing a freeze on enrollment, attrition, and other as yet unspecified money-saving measures.

LePage said Monday that he would veto the budget if it does not eliminate coverage for childless adults. DHHS Commissioner Mary Mayhew said the governor also wants cuts to the parents program. LePage spoke with television and radio outlets on Tuesday, but refused a request for an interview from MaineToday Media.

“I’m looking to develop a self-reliance type of state,” he told WCSH-6. “They want the nanny state and I’m going to fight that.”

House Minority Leader Emily Cain, D-Orono, said the committee was close to consensus Tuesday night.

“Despite the antics of the governor today and yesterday, the committee seems to be on track,” she said.

Members of the Appropriations Committee met off and on throughout the day to try to come to consensus. So far, they’ve agreed to about $58 million, which includes cuts to services, savings initiatives put forward by the department and the collection of over payments to providers.

There’s also a proposal to move $60 million from one fiscal year to another to help close the gap.

After the budget is approved, the committee will work on an additional $80 million that’s needed to balance the second year of the budget. That portion includes a deficit created in January when the committee rejected LePage’s proposal to close all private non-medical institutions on July 1.

Also, the committee has delayed votes on cuts to three programs that require permission from the federal government. That includes cuts to the Medicare Savings Program, which helps low-income elderly Mainers pay for prescription drugs, a further tightening of income eligibility for parents, and ending Medicaid health insurance coverage for 19- and 20-year-olds.

Susan Cover — 620-7015

[email protected]

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