Thursday, April 17, 2014
Lawmakers have made progress on a measure to use revenue from the state's next wholesale liquor contract to pay off Maine's debt to its 39 hospitals, but Democratic leaders differ on whether the bill should be tied to an expansion of MaineCare.
Democrat John Tuttle, of Sanford, the Senate chair of the Veterans and Legal Affairs Committee, said Wednesday that linking the expansion of MaineCare -- Maine's Medicaid program -- to the hospital payback plan is a bad idea.
He said the issues should be dealt with separately to ensure that the policies don't get mired in a partisan fight.
"I just hate to see everybody jump into a firestorm," he said. "I'm all for health care, but I think there's a right time to do it, and I think we have to allow the committee process to work itself out."
Tuttle's committee is considering draft language of a bill for a liquor contract to replace the state's 10-year deal with Maine Beverage Co., which expires in 2014.
Gov. Paul LePage wants to use money from the contract to pay off the state's $186 million debt to its hospitals for Medicaid reimbursements. That would release $298 million in payments from the federal government.
Many Democrats, who have majorities in the House and Senate, have said they want to link the repayment of hospital debt to the expansion of Medicaid.
An analysis by the Kaiser Family Foundation has projected that Maine will save $690 million in the next 10 years if it accepts federal dollars under the Affordable Care Act to provide care to about 55,000 Mainers.
Tuttle acknowledged pressure from Democratic leaders to tie the repayment of the hospitals to the Medicaid expansion. But Tuttle said doing so could jeopardize a bill that has a chance of gaining bipartisan support.
"Medicaid expansion has to be done in an appropriate manner. I'd hate to see everything combined in one bill. Politically, that really puts us in a bad position," Tuttle said.
"The House is pushing this, big time," Tuttle said. "I can identify with that, but you have to let the process work out."
He said Senate Democrats aren't completely on board with linking the two proposals.
Another Democratic leader, House Speaker Mark Eves, of North Berwick, has made Medicaid expansion a policy priority. Eves has said that expanding health insurance to low-income Mainers is the right thing to do financially and morally.
"It's possible and it's necessary to have it in the same bill," Eves said. "We are committed to it happening and happening together" with the liquor bill.
Eves said he believes Tuttle will eventually reach the same conclusion.
Accepting federal funds for the Medicaid expansion "is a deal that can't be passed up," Eves said.
Tuttle later said he believes that the various sides "are not that far apart" but the issues must be debated in committee.
House Minority Leader Kenneth Fredette, R-Newport, said he is confident that the Veterans and Legal Affairs Committee is moving in the right direction.
"If we leave them alone, I think they'll get it done," Fredette said in a radio interview with WVOM.
When asked if he is surprised by Tuttle's stance, Fredette said, "Senator Tuttle is someone I think has distinguished himself as someone who will work in a bipartisan fashion and who will look at issues as issues and not necessarily along party lines."
Sen. Garrett Mason, R-Lisbon Falls, said he opposes linking Medicaid to the liquor contract.
"As far as I'm concerned, there's no appetite for Medicaid expansion attached to this bill," he said. "The Democratic leadership has moved the goal posts."
The Veterans and Legal Affairs Committee aims to meet next week to discuss the liquor bill further. The committee already has dismissed the notion of an upfront payment being part of the bidding process.
Still to be debated is whether the winning bidder should get a set fee for providing service or negotiate a profit-sharing plan with the state, Tuttle said.
"We will go with the best financial plan for the state," he said.
State House Bureau writer Steve Mistler contributed to this report.