- Associated Press - Tuesday, January 14, 2014

AUGUSTA, Maine (AP) - Independent Eliot Cutler on Tuesday attacked Republican Gov. Paul LePage for the first time in the gubernatorial race over a report that says expanding Medicaid would be too costly. Meanwhile, Democratic lawmakers raised questions about the report’s methodology.

Cutler said the report’s conclusion that poverty is growing and that expanding Medicaid would be unsustainable underscores why the governor should be “fired.”

“The one contribution that this report has made is to show that Governor LePage’s own policies are a failure and that he has no plan to grow Maine’s economy into one that generates jobs instead of poverty,” Cutler told reporters in Portland.

In Augusta, skeptical lawmakers questioned why the report by the Alexander Group looked only at factors driving up expenses and didn’t consider cost-saving measures.

Gary Alexander and an associate told the Health and Human Services Committee that they focused on established factors like the poverty rate instead of various cost-saving initiatives that they said were unlikely to realize substantial savings.

Part of the nearly $1 million report commissioned by the LePage administration found that Medicaid expansion under the Affordable Care Act would cost the state $807 million over the first decade, even with the federal government footing the bill for the first three years. The rest of the report, which aims to address financial challenges in the state’s Medicaid program and help the state obtain flexibility from the federal government, has not yet been released by the administration.

Democrats remain unconvinced, saying that expanding health care would actually lower costs by reducing hospital charity and emergency room visits.

The Legislature planned Wednesday to open Round 2 of debate on Medicaid expansion. LePage vetoed a similar bill during the last session.

In Portland, Cutler called a news conference in which he said the Alexander Group report contained made-up numbers that suggest Maine’s poverty rate will grow at a rate faster than anyone else has projected, resulting in inflated numbers designed to support the governor’s opposition to expanding Medicaid.

“Anybody can manufacture numbers out of whole cloth,” he said.

He said it’s “morally wrong and financially crazy” not to expand Medicaid to another 70,000 residents under the federal health care law. He would sign the bill, but said that his bigger goal would be to expand health care to all Maine residents.

Brent Littlefield, spokesman for LePage, suggested Cutler was “desperate for attention” and wanted to steal the spotlight.

“The fact is not only has Governor LePage paid off a massive hospital debt left over from past welfare mistakes, but his policies have also resulted in the creation of over 10,000 new private sector jobs and the lowest unemployment rate since 2008,” he said.

Democratic Rep. Mike Michaud, who’s also running for governor, said LePage should be focusing on expanding health care instead of spending money on the report. “It’s clear that this was an illegitimate report that was a complete waste of taxpayer funds,” he said in a statement.

In Augusta, the hour-long session featuring Alexander, his associate Erik Randolph and Health and Human Services Commissioner Mary Mayhew grew tense at times.

Rep. Drew Gattine of Westbrook suggested that the report was “in some respects a step backwards” and that it was “a repackaging of things we’ve been hearing.” Rep. Peter Stuckey suggested the report focused too much on costs instead of people.

Mayhew, the DHHS commissioner, said she took offense to any suggestion that the DHHS has been too slow to come up with ideas, data and solutions for dealing with growing Medicaid costs.

“The bottom line is we don’t have unlimited resources in this state. There are difficult decisions that have to be made as part of this discussion,” she said afterward.

For his part, Alexander conceded that there could be cost savings through creation of “health homes” and “accountability care organizations” under the Affordable Care Act that could lead to long-term cost savings. But he said those were not in the report because the state can take those steps regardless whether it expands Medicaid.

Randolph said other cost-savings variables also were left out.

“As a scientist, you have to isolate the variables and only change the one variable that you want to study. … That gives you a cleaner comparison of the test case, the expansion scenario, versus the base line,” he said.

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Follow David Sharp on Twitter at https://twitter.com/David_Sharp_AP

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