August 2, 2012

Federal officials say some Medicaid cuts requested by LePage are questionable

BY GLENN ADAMS, The Associated Press

AUGUSTA -- Some cuts in Medicaid eligibility being sought by Gov. Paul LePage's administration appear to be allowed under the law, but others raise questions, a federal official said Thursday as a review of the state's request for approval of the reductions got under way.

The federal Department of Health and Human Services' Centers for Medicare and Medicaid Services said it had received a formal request filed a day earlier by the state, which contends the cuts, amounting to $20 million in savings, are needed to balance the state budget.

The planned cuts, due to take effect Oct. 1, cover three areas. They would eliminate Medicaid coverage for 19- and 20-year-olds, cut back access to Medicaid for elderly people already eligible for Medicare and increase eligibility requirements for non-disabled, non-pregnant adults on Medicaid.

The third option appears to be allowable, CMMS spokesman Brian Cook said in an email.

The savings resulting from stiffer eligibility requirements for low-income parents on Medicaid account for $12.7 million, more than half the savings the state would realize from all three program cuts. They also would affect more than 27,000 people, three-quarters of those affected by all the cuts.

Cook said Maine has certified its budget deficit, permitting it to end Medicaid coverage for adults with incomes above 133 percent of the federal poverty line who aren't disabled or pregnant. He said the CMMS will work with the state as it seeks to implement the change.

"We share Maine's longstanding commitment to covering the uninsured and understand that Maine, like all states, operates under budget constraints," Cook said.

The email added that Maine's new request also would end coverage for other people enrolled in the program. It said Maine appears to acknowledge that this request is inconsistent with the terms of the federal law but the CMMS will review its submission.

LePage, a Republican, made a personal appeal to HHS Secretary Kathleen Sebelius and laid out the state's legal arguments for the cuts in a letter dated Wednesday.

The letter says the decision "is easy for your Department" in part because the U.S. Supreme Court has ruled the government can't take away the states' existing federal Medicaid dollars if they don't expand Medicaid.

LePage also says that, even with the planned cuts, Maine's Medicaid eligibility standards exceed the federal minimums.

The governor asks for a response to the state's request by Sept. 1, otherwise "we will be forced to go to court and seek appropriate relief."

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