AUGUSTA, Maine (AP) - The Maine Senate endorsed a measure on Wednesday to expand Medicaid coverage to roughly 70,000 residents under the federal health care law and privatize the state’s program through managed care in an effort to curb costs, but the plan was dealt a significant blow by failing to get enough support to survive a future veto from Republican Gov. Paul LePage.
The proposal, crafted by two moderate Republican senators, includes several provisions designed to attract GOP votes, but it continues to face staunch opposition from many lawmakers and LePage, who calls Medicaid “welfare,” contends that expanding is too costly and has rejected two previous attempts to do so.
Sen. Roger Katz, a Republican from Augusta who helped write the measure, called it a chance to pump a billion dollars into the Maine’s economy, reform a program that “has been a mess for decades” and prove that divided government can work.
“To mention the word ’expansion’ around here is the political equivalent of throwing off your gloves in a hockey game. It’s an invitation to brawl. It’s us vs. them, pass the ammunition, man the barricades,” Katz said. “It doesn’t have to be that way.”
The 22-13 vote came after several hours of debate over whether to expand the program under the Affordable Care Act - a question that has consumed the Legislature for more than a year. The measure faces further votes in the House and Senate. Two thirds of present-and-voting lawmakers, which in the Senate typically means 24, will have to endorse the measure to eventually overturn LePage’s veto.
The managed care component of the bill seeks to provide budget stability by having the state contract with organizations that would be paid a fixed price per enrollee to run the state’s Medicaid program. Under managed care, implemented in some form in 45 other states, companies aim to control costs by getting patients the preventative care they need.
Democrats called on Republicans to support the compromise to offer life-saving health care to thousands of Mainers who won’t otherwise get it. But critics pointed to the fact that some of the biggest supporters of the proposal are those who last year opposed a stand-alone managed care measure, and questioned whether it would actually save the state any money.
Other Republicans mentioned that many who would qualify for Medicaid under the expansion can buy coverage on the federal exchange for just a few dollars a month with subsides. Having the federal government fund private plans is a better option than growing a state-run program Maine taxpayers will eventually have to fund, they said.
Sen. James Hamper, a Republican from Oxford, dismissed the nonpartisan Office of Fiscal and Program Review’s estimate that the bill would only cost the state about $683,520 over the first three fiscal years and warned that expanding Medicaid will have “immense, ongoing costs,” crowding out funding for other essential programs.
“When will this body learn? If you vote for Medicaid expansion … you are voting to dedicate 38 percent of the general fund to this behemoth,” he said.
The new proposal includes several other provisions designed to get GOP votes, including an attempt to reduce the waitlist for service in Medicaid and putting two new fraud investigators in the attorney general’s office. It also includes several components of the bill that failed last year, such as allowing the state to withdraw from the expansion after three years, when the federal government begins to gradually lower its share of the cost from 100 percent to 90 percent or more.
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