February 22, 2013

Lawsuit targets Medicaid cuts in Maine

A lawsuit is filed on behalf of five Maine residents.

By Matt Byrne mbyrne@pressherald.com
Staff Writer

A Maine anti-poverty group is suing the Obama administration in an attempt to halt cuts to a Medicaid program that helps roughly 6,000 low-income or disabled Mainers pay their medical bills.

click image to enlarge

Louis and Katherine Bourgoin of Lewiston are two of the more than 6,000 Mainers who face losing health care provided through Medicaid. A federal lawsuit filed this week names the Bourgoins and three other Mainers who are disabled or low-income.

Shawn Patrick Ouellette/Staff Photographer

The suit, announced Thursday, was filed earlier this week in U.S. District Court in Portland by Maine Equal Justice Partners on behalf of five residents who are disabled or low-income. It challenges a decision by the U.S. Department of Health and Human Services that allowed Maine to tighten eligibility standards for the supplemental assistance program starting March 1, and asks for a temporary restraining order to block them from taking effect in the meantime.

"I'm almost 70 years old," said Katherine Bourgoin of Lewiston, one of five affected Mainers named in the suit. "What are we going to do?"

The suit says Bourgoin and her husband, Louis, 68, are among the thousands in the state who qualify for Medicare -- the federal health care program for seniors -- but whose incomes are too low to pay for associated costs such as deductibles, co-pays and medications. The Medicaid program helped fill in the gap.

Bourgoin said Thursday that she and her husband subsist on Social Security payments and a small pension. If the new rules go into effect March 1, their fixed monthly income of $2,400 will exceed the new eligibility limit by $100 a month, she said.

"I'm going to be cutting back on medication and medical treatment that I need," she said. "I don't think it's fair."

The waiver granted by the federal agency last month allows the LePage administration to tighten eligibility rules for the Medicaid program, which is funded with state and federal money. The reduced eligibility would save the state $5.6 million annually.

Medicaid, or MaineCare as it is called in Maine, is a national program run by individual states. It is paid for by federal and state funds, and changes in eligibility requirements must be approved by the federal government.

The Bourgoins would lose about $1,970 in benefits including coverage for deductibles, according to the lawsuit.

Jack Comart, litigation director for Maine Equal Justice Partners, said the lawsuit hinges on a section of the Affordable Care Act that mandates states not change Medicaid eligibility requirements until the state-run healthcare exchanges are established in 2014, except for very specific cases concerning an impending budget deficit.

However, Comart said, the law stipulates that the poor and disabled may under no circumstances be cut from Medicaid during the transition period, regardless of budget considerations.

"(The waiver) was unexpected because the law is so clear," Comart said.

The waiver granted to Maine was rare, if not unprecedented.

Adrienne Bennett, a spokeswoman for Gov. Paul LePage, said in a statement that the state faces significant budget challenges, and that the waiver offers greater flexibility to ensure MaineCare continues to serve its core mission.

"Unfortunately, Maine cannot afford to pay for welfare for 1 in 3 Mainers and it is forcing the state to prioritize limited resources and scramble for money in other areas of government, including education, to fill the gap," Bennett wrote.

Bennett also cited the decline in federal match-funding for Medicaid, which has slid from nearly 75 percent matched in 2010, to about 62 percent in 2013, creating a new $210 million state obligation. Further reductions in federal match-funding are expected in 2014, she said.

The lawsuit, which requests class-action status for the roughly 6,000 disabled or low-income Mainers, does not address the 12,592 working parents who still stand to lose Medicaid coverage March 1 under the waiver.

The parent group will be excluded from coverage because their earnings fall between 133 percent and 200 percent of the federal poverty line -- $31,332 to $55,140 for a family of four, according to the 2013 poverty guidelines.

House Speaker Mark Eves said state Democrats have been consistent in their support of MaineCare, and have argued that the federal green light to cut the program will force Maine's seniors to choose between medical treatment and other necessities, such as heating their homes.

In addition to the Bourgoins, the lawsuit names Heidi Brooks of Lewiston, Katherine Sherrard of Kennebunk, and Donna Stevens of Waterville.

Comart said a federal judge will hear arguments on the temporary restraining order during a Friday telephone conference.

Staff Writer Matt Byrne can be contacted at: 791-6303 or at

mbyrne@mainetoday.com

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