December 5, 2013

Maine DHHS chief: Medicaid expansion 'unsustainable'

Commissioner Mary Mayhew’s visit comes amid continuing controversies at her agency.

By Steve Mistler
Staff Writer

Gov. Paul LePage’s health and human services chief told Portland-area business leaders Wednesday that Maine should not expand its Medicaid program through the federal health care law.

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Mary Mayhew, commissioner of the Maine Department of Health and Human Services, speaks at the Portland Community Chamber’s Eggs ’N Issues breakfast at Holiday Inn By the Bay in Portland Wednesday.

John Patriquin / Staff Photographer

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Health and Human Services Commissioner Mary Mayhew was the keynote speaker at the Portland Regional Chamber’s Eggs ‘N Issues breakfast. She focused on making the case against expanding Medicaid, at a time when the department is dealing with controversies including a plan to move its Portland offices to South Portland, a failing rides system for Medicaid recipients and the hiring of an out-of-state contractor to evaluate its public benefits system.

Mayhew addressed all three controversies with reporters after her remarks at the Holiday Inn by the Bay.

In her speech, she said Maine’s current Medicaid program, MaineCare, is crowding out other state funding priorities.

“This explosion in cost and enrollment is unsustainable,” Mayhew said, and “without reform and change it’s unsustainable.”

Medicaid expansion, a key component of the Affordable Care Act, is a partisan issue in state houses across the country, including Maine. Most Republican administrations, including LePage’s, have opposed expansion, a strategy that coincides with other efforts to resist implementation of the federal health care law.

LePage vetoed two legislative efforts to expand Medicaid earlier this year. Democrats, who have majorities in the Legislature, will try again when lawmakers reconvene for an emergency session in January.

Both sides in the debate have intensified their public relations campaigns over an issue that may play into the 2014 legislative and gubernatorial elections. Additionally, President Obama has begun pressuring Republican governors to expand Medicaid.

In Maine, advocates say expansion would provide health insurance to more than 60,000 low-income residents, with the federal government paying 100 percent of the expansion costs before gradually drawing down to 90 percent reimbursement.

Mayhew said the budget turmoil this year in Washington, D.C., should be a warning against assuming that the federal government will be able to keep its funding promise. Even if the federal dollars arrived as promised, she said, the state would pay $150 million a year.

Mayhew also drew a rhetorical link between the state’s reliance on federal dollars and a welfare system that should not be “the goal or the finish line” for beneficiaries. She said Maine should evaluate its “insatiable appetite for federal dollars, in particular Medicaid dollars,” which have “blurred lines” between assistance and “dependency.”

House Speaker Mark Eves, D-North Berwick, said in a written statement that Mayhew’s speech was a continuation of her department’s “effort to deny and delay health care to tens of thousands of working Mainers, including nearly 3,000 veterans.”

In her remarks before the business community, Mayhew said the state’s current $2.4 billion in Medicaid spending takes most of the DHHS’ $3.4 billion annual budget.

She said previous expansions have put the most needy on waiting lists for coverage. And, she said, the program creates “annual shortfalls of tens of millions of dollars” and is “perpetually suffering from financial challenges.”

Eves responded by saying, “Businesses in Maine know that accepting federal health ccare dollars to cover working Mainers is a good deal. No business leader would turn away an additional $700,000 a day for their company because of politics. But that’s what Gov. LePage is doing. Starting on Jan. 1, Maine will lose out on an additional $700,000 a day while nearly 25,000 Mainers lose care.”


The DHHS is the subject of controversies that include a plan to move its Cumberland County regional office from Marginal Way near downtown Portland to a site nearly four miles away, near the Portland International Jetport. Opponents say the move would make it harder for people who seek public assistance to get it.

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