A look at the Medicaid expansion debate in Maine

AUGUSTA, Maine (AP) - Dozens of people poured into a legislative committee room Wednesday as Democrats sought a do-over on their past attempts to expand Medicaid under the federal health care overhaul.

Public hearings on the new bill to expand Medicaid, or MaineCare, are moving forward in the Democratic-controlled Legislature, despite staunch opposition from Republican Gov. Paul LePage’s administration, who says the program is already cash-strapped.

“We need a MaineCare program that is not reeling from one financial crisis to the next,” Health and Human Services Commissioner Mary Mayhew told lawmakers.

Here’s a look at where the Medicaid expansion debate stands in Maine now:

- What’s in the bill:

Almost identical to last year’s expansion bill that LePage vetoed, the new bill also has provisions aimed at getting Republican lawmakers on board. One would allow the state to withdraw from the expansion after three years, which is when the federal government begins to gradually lower its share of the cost from 100 percent to 90 percent or more. The bill would also allow the state to opt out of the expansion if the federal government doesn’t keep its funding promise.

- What’s new:

Democrats say the fact that 25,000 people in Maine either lost health care coverage Jan. 1 or will soon raises the stakes for expanding the program now. But Republicans now point to the troubled rollout of the health care law in their opposition to expand. Another new component in the debate is a recent report commissioned by the LePage administration that concludes that the expansion could cost the state $807 million over the first 10 years.

- The numbers debate:

The biggest questions surrounding the expansion recently have been on its cost. The administration report says the costs to the state would be significant, even with the federal government footing the bill for the first three years. But advocates and Democrats say the report looked only at factors driving up expenses and didn’t consider cost-saving measures.

- What’s next:

Democrats hope to get the bill through quickly this session, which means debate in the full House and Senate chambers could happen soon. Democrats are working under the assumption that even if the bill passes the Legislature, it will be vetoed by LePage. If that happens, they’ll need a vote of two-thirds present and voting in both chambers to override the veto. Efforts to do so last year fell short by a handful of votes.

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