AUGUSTA — Maine is not alone among the states that have reduced spending for Medicaid programs, a health care spending consultant on Tuesday told a panel that’s looking to add to cuts that already have been imposed.

Cuts elsewhere range from eyeglasses and eye exams to hearing aids, dental care, chiropractic services and mental health services, according to a summary prepared by Seema Verma of SVC Inc. for the MaineCare Redesign Task Force.

“A lot of the states are in a similar situation where they’re looking for cost-containment strategies,” Verma, of the Indiana-based consultancy, told the task force. “There are no easy answers to this. Any decisions you make will have advantages, will also have some disadvantages.”

Medicaid already has undergone major cuts in Maine, notably coverage for 19- and 20-year-olds, reduced access for elderly people already eligible for Medicare and increased eligibility requirements for non-disabled, non-pregnant adults on Medicaid. But even while the Legislature is adjourned, the search for more cuts continues.

Gov. Paul LePage says the costs of Medicaid, known in the state as MaineCare, are unsustainable over the long term. As part of the state budget update that was passed in May, the Legislature created the nine-member task force, whose members have expertise in health policy and health care finance.

The panel must find $5.25 million in savings this fiscal year, then formulate longer-term strategies. Among the first approaches taken by other states is increased cost sharing through larger co-pays, a strategy some states see as an incentive for people receiving benefits to take more personal responsibility, Verma said.


But she warned that the states may not be able to change standing cost-sharing rules because of national Affordable Care Act restrictions on such changes. She also said increased cost sharing may have a downside in the form of reduced access to care.

“A lot of times the providers feel it’s not worth the effort in terms of collecting this,” Verma told the panel. “It requires more administrative costs, and sometimes cost sharing or co-pays can be construed as a provider cut because they won’t end up collecting those and that’s a decrease in their reimbursement.”

A common cost-containment strategy has been benefit changes, with more than 15 states imposing new limits in the last two fiscal years, the consultant’s study shows. Typical benefits targeted for reduction include home health and personal care, dental, vision and physical, speech and occupational therapy, according to the study, which listed as a source the Kaiser Foundation.

Fourteen states have reduced coverage for dental care or dentures, four have reduced mental health services and three vision services during the last two fiscal years.

Maine’s study comes amid uncertainty about the state’s own looming costs. State officials are awaiting word from the federal government on whether it will accept MaineCare cuts that account for $20 million in the state budget. State Department of Health and Human Services Commissioner Mary Mayhew said before Tuesday’s meeting that the task force may have to address that issue, depending on the federal decision.

More than 361,000 Mainers are enrolled in MaineCare.

Comments are no longer available on this story