Mainers for Health Care rally outside the State House before Gov. Paul LePage’s State of the State address in February. Associated Press/Robert F. Bukaty

AUGUSTA — Advocates for expanding Medicaid in Maine sought Tuesday to keep pressure on the LePage administration, even as Attorney General Janet Mills announced a $35 million legal windfall she said could pay for expansion.

Tuesday was the deadline for the Maine Department of Health and Human Services to file a plan with federal regulators for how the state planned to expand Medicaid coverage to an estimated 70,000 additional adults as part of a ballot initiative approved by Maine voters last November. But Gov. Paul LePage has said repeatedly that his administration would not move forward with implementation until the Legislature fully funds expansion, raising the specter of potential legal challenges.

On Tuesday, expansion advocates held a news conference calling on LePage to submit the state’s implementation plan to the federal Centers for Medicare and Medicaid Services.

House Speaker Sara Gideon, D-Freeport, said she was hopeful the LePage administration would do its job and submit the application for the waiver the state would need to move forward with expansion.

“Our bipartisan Appropriations Committee will continue to work towards implementing Medicare expansion fully so that 70,000 of our neighbors can finally afford access to health care,” Gideon said. “We will appropriate the funds that are necessary when we need them. That is the job of the Legislature as a separate but equal branch of the government and we will determine when that day is.”

CONFLICTING ASSESSMENTS ON COST

Last November, 59 percent of voters supported the ballot measure directing Maine to join the more than 30 other states that have expanded Medicaid as part of the Affordable Care Act.

There are conflicting assessments for how much expansion would cost the state even with the federal government footing 90 percent of the bill. While a recent study funded by the Maine Health Access Foundation estimated it will cost roughly $30 million in the current two-year budget, the LePage administration has pegged the costs at $60 million during the first year and as much as $100 million annually in future years.

Mills, meanwhile, announced Tuesday that her office and attorneys general in eight other states had reached an agreement with tobacco companies that will result in an additional $35 million for Maine as part of a 1998 legal settlement with the industry. Mills, one of seven Democratic primary candidates for governor, said that state law requires money from the historic settlement with tobacco companies to be used for “health care for children and adults, maximizing to the extent possible federal matching funds.”

“In other words, these funds are available to pay for Medicaid expansion as enacted by the people last November in the current biennium,” Mills said in a news conference held immediately after the event organized by Medicaid expansion advocates. “There is overwhelming evidence that states which have taken advantage of Medicaid expansion experience lower health care costs, healthier families and stronger economic growth.”

MILLS: TIMING WAS COINCIDENTAL

Mills said the agreement was finalized in the past several weeks, but that the timing of her announcement and Tuesday’s Medicaid expansion events was coincidental.

The Legislature would need to approve spending the additional settlement money – which is deposited into the Fund for a Healthy Maine – on Medicaid expansion. Given the politics surrounding Medicaid expansion, it was unclear Tuesday whether such a vote is feasible before the legislative session ends later this month.

Asked whether her proposal had legislative approval, Mills responded: “I can’t imagine why they would oppose it. It’s a gift.”

LePage fired back later Tuesday with a statement accusing Mills of consistently opposing past administration efforts to use tobacco settlement money for Medicaid programs.

“This political stunt would be nothing more than a down payment on giving free health care to 80,000 people, which will require ongoing and sustainable long-term funding,” LePage said. “If the Attorney General thinks a one-time settlement is enough to fund Medicaid expansion, she won’t make a very good governor.”

Organizations such as Mainers for Health Care, which led the Medicaid expansion ballot initiative, have threatened to pursue legal action against the LePage administration if it does not begin to implement the law. Mills declined to comment on whether her office would represent the LePage administration in any hypothetical lawsuit, but indicated that she believes the administration should be moving forward with implementation.

“The law is the law. Medicaid expansion has been enacted into law by the people,” Mills said. “There is really, in my view, no legal way to get around that. And the funds are available to get us through the biennium.”

Kevin Miller can be contacted at 791-6312 or at:

[email protected]

Twitter: KevinMillerPPH

 

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