AUGUSTA, Maine — Legislative leaders are expected to be presented Tuesday with Gov. Paul LePage’s supplemental budget for the Department of Health and Human Services that addresses an estimated $121 million shortfall.

While the specifics of that budget are still unknown, details have emerged, including some from the governor himself.

In his weekly radio address on Saturday, LePage said that the state can no longer afford to allow low-income adults without children to enroll in Medicaid.

Since 2002, when that provision was created, the number of childless adults, or noncategoricals, in Medicaid has grown from less than 3,000 to nearly 19,000. If that category is eliminated, it could save the state $40 million over two years.

“People who fall into this category have no [dependent] children in the home, are not pregnant and are not disabled,” LePage said. “Maine is one of only 15 states that offer this benefit. Basically, this is free health care for 19,000 Mainers … The fact is — we can no longer afford it.”

Another area under consideration is lowering the Medicaid eligibility threshold in Maine from 200 percent of poverty level to 150 percent or even 133 percent, which is in line with a majority of other states. It’s not clear how much money that would save.

Still another option is eliminating some of the services offered under MaineCare, the state’s Medicaid program, including dental. Should the state have to pay for dental care for low-income Mainers when many working people who have health insurance do not have dental care covered by their employers?

During a recent meeting with members of the Bangor Daily News’ editorial department, DHHS Commissioner Mary Mayhew acknowledged the enormity of the fiscal reality facing her department and said Medicaid would likely bear the brunt of cuts.

LePage agreed during his radio address.

“We spend more on Medicaid per person than the national average. We have continually increased Medicaid eligibility at a higher rate than the national average,” he said. “Total spending, state and federal, on Medicaid has increased by over $1 billion in 10 years; a 45 percent increase, but it’s still not enough. Maine’s population on Medicaid is 35 percent above the national average.”

Whether any other areas of DHHS could see cuts is unclear. Gov. LePage has supported other cost-cutting options at DHHS in the past, including various types of welfare reform.

During discussion of the $6.1 billion biennial budget that passed in June, the governor recommended reducing the amount of general assistance the state passes to cities and towns. That provision was stripped after leaders in Maine’s largest communities — Portland, Bangor and Lewiston — said the cuts would disproportionately affect them.

General assistance cuts could well be back on the table, but the governor stressed Saturday that he would protect the state’s safety net for the elderly, the disabled and children.

Rep. Peggy Rotundo of Lewiston, lead Democrat on the Appropriations Committee, said Monday she still doesn’t have a strong grasp of the DHHS shortfall.

“I’m still concerned about the numbers coming from DHHS; they are soft numbers that have not been fully substantiated and I’m concerned about making any decisions until we have a clear sense of the numbers,” she said.

The governor made another thing clear in his weekly radio address: His background is in business and he intends to run the state like a business. That means being decisive even when the decisions are going to face criticism.

“No administration wants to take away anything from anyone, but at the same time, as policymakers, we have to be held accountable for our spending and refrain from gimmicks to get us by,” LePage said. “No question, tough decisions will have to be made. But then again, that’s why I signed up for the job.”

The governor recently threatened to cut funding to education if lawmakers did not support cuts to MaineCare and other welfare programs.

Once lawmakers received the DHHS supplemental budget, the window of time appears small for the details to be worked through.

Next week, there will be public hearings on the specific cuts. The following week, members of the Appropriations Committee and the Health and Human Services Committee will conduct work sessions on the budget bill.

Adrienne Bennett, the governor’s spokeswoman, said Monday that the administration’s goal is to have the budget passed early in the Legislature’s 2nd regular session that convenes on Jan. 4. Every month the state waits, she said, costs tens of millions of dollars.

If the governor wants the budget to go into effect immediately, though, it would need to pass through the Legislature in emergency fashion. That means a two-thirds majority would need to support it, meaning some Democrats would have to get on board.

It’s likely that once Gov. LePage deals with DHHS, he will introduce another supplemental budget that addresses the rest of state government. Some Democrats already have expressed concerns about passing a supplemental DHHS budget in such a vacuum.

“I’ve heard about some of the programs he’s thinking about cutting and I have reservations about rejecting policies that were voted on in a bipartisan way,” Rotundo said. “We need to look at cuts in a comprehensive way.”

BDN reporter Jackie Farwell contributed to this story.