- Associated Press - Wednesday, December 13, 2017

AUGUSTA, Maine (AP) - Maine faces a July deadline for expanding Medicaid as lawmakers scramble to figure out exactly how much it will cost and how the state will pay for it.

The Legislature’s appropriations committee met Wednesday to start coming up with an official estimate of the costs and savings of Medicaid expansion. So far, lawmakers have offered no ideas about how to pay for the expansion.

Voters approved an initiative that estimated Medicaid expansion would cost the state $54 million once fully rolled out, an amount that includes an estimated $27 million in annual savings from reduced health care costs. It could cost the state about $2.5 million a year in administrative costs.

But Gov. Paul LePage claims the Legislature’s Office of Fiscal and Program Review is vastly underestimating the cost.

LePage wants lawmakers to have the money in the bank before his administration starts the work of expanding Medicaid. His critics, such as the liberal Maine Center for Economic Policy, say he’s simply trying to delay expansion as he nears his last full year as governor.

“Many politicians conveniently forget that the last time Maine expanded Medicaid, it blew holes in the budget every year,” LePage said in a recent radio address. “The Legislature lurched from crisis to crisis and scrambled to find one-time gimmicks to fund the budget. We cannot let the past repeat itself.”

Democratic Rep. John Martin, a member of the appropriations committee, said lawmakers have to take funding the voter-approved Medicaid expansion law seriously. Legislative analysts say after the law becomes effective Jan. 3, the Department of Health and Health Services must apply to expand Medicaid by April 3 and then expand it by July 2.

“We have to deal with it, whether we like it or not,” Martin said.

Expansion could cost $55 million in the fiscal year starting in July, said Luke Lazure, an analyst for the Office of Fiscal and Program Review. That figure doesn’t include projected savings, which includes the money the state currently spends on mental health and substance abuse treatment for people who could be eligible for the federal-subsidized coverage under the expansion.

As health care costs increase and the share of federal funding decreases to 90 percent in 2021, Medicaid expansion could cost Maine $67.8 million in fiscal years 2020, and $78 million by fiscal year 2021. Former Democratic President Barack Obama’s health care law, which Republican President Donald Trump wants to repeal - would provide about $500 million in federal funding annually.

Expansion could cover up to 90,000 people, including Mainers who lost Medicaid coverage under the LePage administration, Lazure said. About 10,000 insured people would be eligible for Medicaid under an expansion.

The LePage administration has pointed to other states that have seen higher-than-expected enrollments to argue Maine could see the same, Lazure said.

Committee members say they need answers from the LePage administration to put together an accurate estimate.


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