Mainers who care for their disabled spouses at home could be reimbursed by Medicaid if a bill sponsored by a Windham legislator becomes law.

The measure went before the Legislature’s Health and Human Services Committee for a public hearing Thursday, with several people testifying in favor and no one speaking in opposition. Medicaid rules in Maine, where the program is called MaineCare, now bar spouses from being paid for giving in-home care.

Rep. Patrick Corey, R-Windham, said he sponsored the bill because he saw a need for a reform that would promote keeping families at home and out of institutions.

“Keeping patients at home in the long run will cost taxpayers less money,” Corey said.

Medicaid is a federal program operated by the states and funded with a blend of federal and state tax dollars. States have some latitude to choose what they will reimburse for, and 12 states currently compensate spouses for providing in-home caregiving for a disabled spouse. Vermont is the only New England state to pay spouses for these services.



In Maine, the caregiving spouse would be eligible to earn about $11 to $12 an hour. About 35,000 Mainers receive Supplemental Security Insurance under Medicaid, which includes people with disabilities and extremely low-income seniors.

Medicaid rules in Maine now allow other people who are living in the home and providing caregiver services – such as adult children or siblings – to be reimbursed for that work, but spouses are excluded.

An identical bill was approved by the Maine Legislature last year, but the measure died on the special appropriations table because it wasn’t funded. The projected cost of that bill was $2 million in federal and state money. MaineCare serves about 255,000 Mainers at a cost of $2.5 billion.

Advocates for the disabled at Thursday’s hearing said that the cost of the bill should be seen in a broad context, because keeping people at home and out of nursing homes saves money in the the overall system.

For instance, nursing home care costs about $75,000 to $100,000 per person annually, according to testimony before the committee, while paying a spouse to provide in-home care for one year would run about $25,000.



Sara Squires, public policy director for Disability Rights Maine, said many people caring for a spouse at home have had to quit their full-time jobs to do so.

“This bill will provide some economic relief for families who have to choose between caring for a loved one and holding down a job,” Squires said.

Patricia Thorsen, program manager for the Maine Long-Term Care Ombudsman Program, noted that a spouse would have to be hired by an agency as an in-home worker in order to be paid for their services.

“They would still have to be hired by an agency and pass background checks,” Thorsen said. “They would have to demonstrate the same level of ability” as an in-home worker who is not a spouse.

Thorsen said many agencies are dealing with a workforce shortage because of low pay and Maine’s low unemployment rate. Last year, the Legislature did approve a slight increase in reimbursement rates for caregivers, but pay remains low and Maine’s minimum wage is due to increase to $12 an hour in 2020.

Joe Lawlor can be contacted at 791-6376 or at:

Twitter: joelawlorph

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