An advocacy group that is suing the LePage administration for failing to expand Medicaid, even after voters overwhelmingly approved it, filed legal briefs in court Friday countering recent assertions by the governor that he can’t implement the expansion until the Legislature allocates funds for it.

In a 21-page brief filed in Kennebec County Superior Court, Maine Equal Justice Partners argued that there’s enough money in place to implement the expansion this year, and that the LePage administration is flouting the law by not making any moves to expand Medicaid. Republican Gov. Paul LePage is a staunch opponent of Medicaid expansion and he has vetoed several attempts by the Legislature to do so, although the governor can’t veto a law approved by referendum.

Maine Equal Justice Partners led the Medicaid expansion campaign that resulted in voters approving a referendum in November – 59 percent to 41 percent – to expand the program that provides insurance to low-income Mainers.

If the lawsuit is successful, the LePage administration would be compelled to expand Medicaid. Medicaid expansion is a cornerstone of the Affordable Care Act, and so far 32 states, including Maine, and the District of Columbia have approved expansion.

“This court can, and must, resolve this case without delving into any dispute about what funds are (or are not yet) appropriated to fund the Medicaid program,” according to the court filing.

In the brief, attorneys for Maine Equal Justice Partners argued that the administration cannot fail to implement laws it doesn’t like. The LePage administration was supposed to file documents with the federal government – called a State Plan Amendment – in April to begin implementing Medicaid expansion and have the program ready for residents to enroll in by July, but failed to do so, the brief says. Medicaid is a blended federal-state program that uses federal and state dollars, but is operated by the states under federal rules.

“Submission of a (State Plan Amendment) does not require any funds not already available,” according to Maine Equal Justice Partners’ court filing. “And it is no defense to the current action that there may come a time in the future where either the executive or the legislative branch might need to act to ensure there continue to be sufficient allocated funds within the Medicaid program to pay a particular required benefit.”

But the LePage administration argued in a court filing on May 14 that the Maine Department of Health and Human Services “plainly lacks legal authority” to spend money on Medicaid expansion without the Legislature making a specific allocation for the expansion.

“Until (the Legislature) adequately funds it, there is nothing we can do,” LePage said in a statement Thursday. “Before we can proceed with expansion, DHHS needs both the staff to implement it and the money to pay the bills that will come due when the State Plan Amendment is approved” by the federal government.

About 70,000 Maine adults who earn up to 138 percent of the federal poverty limit – $25,100 for a family of four – would be eligible for Medicaid once expansion is approved.

Lawmakers approved an initial $3.8 million expenditure in April to enable DHHS to hire additional staff and cover administrative costs of expansion. However, that funding was caught up in a partisan standoff when the Legislature adjourned on May 2 before funding a number of bills.

Fully funding Medicaid expansion would cost about $45 million in state money in the first full year of implementation, according to the nonpartisan Office of Fiscal and Program Review, and would increase to $55 million by 2021.

Accepting Medicaid expansion would also unlock more than $500 million per year in federal funds that would begin coming to Maine to cover health care costs for enrollees.

If the court case is not resolved by this year, the issue will fall to the next governor. LePage is leaving office in January, and several Democrats, Republicans and independents are vying to replace him.

 


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