AUGUSTA, Maine — The LePage administration won’t get a decision from the federal government as soon as it wanted on its request to make about $20 million in cuts to the state’s Medicaid program.
The federal Centers for Medicare and Medicaid Services said Friday it’s still reviewing Maine’s request for an amendment to its so-called Medicaid state plan. In a letter to LePage, acting administrator Marilyn Tavenner noted that the Medicare and Medicaid office has 90 days to review such a request.
“I appreciate that your budget is predicated on the savings anticipated from ending the Medicaid coverage of the groups of individuals at issue in the proposed [state plan amendment], but your request raises issues that require careful consideration by HHS,” she wrote.
The LePage administration submitted its request for the Medicaid plan amendment on Aug. 1 and requested an expedited decision, by Sept. 1, so the state could implement the cuts by Oct. 1. Since the federal government is allowed 90 days to rule on the amendment request, Maine should have a decision in hand by the end of October, well after the cuts were to have taken effect.
The administration had been counting on the Medicaid cuts — approved by Republican lawmakers as part of a spring supplemental budget package — to balance the state budget.
But it has been uncertain from the start whether many of the cuts would be legal under the Affordable Care Act, which largely prohibits states from making cuts to existing Medicaid services in advance of a 2014 expansion of Medicaid, a program funded by states and the federal government that provides health insurance to low-income residents.
The state cuts would eliminate coverage for 19- and 20-year-olds, tighten income eligibility requirements for low-income parents and scale back Medicaid access for elderly residents who also qualify for Medicare benefits.
While the Supreme Court in June largely upheld the federal health care reform law, the court ruled it unconstitutionally coercive for the federal government to withhold all Medicaid funds from a state that doesn’t participate in the Medicaid expansion.
The LePage administration saw that portion of the ruling as a sign it’s legal to go ahead with cuts to existing Medicaid services simply by applying to the federal government for a routine amendment to Maine’s Medicaid State Plan.
Centers for Medicare and Medicaid Services spokesman Brian Cook said when Maine submitted its request that a part of it would likely pass federal muster: a proposal to change the threshold at which residents qualify for MaineCare from 200 percent of the poverty level to 133 percent. The other cuts, however, appeared to be “inconsistent with the terms of the applicable federal statute,” Cook said.
If the state isn’t able to make the Medicaid reductions by Oct. 1, LePage might have to make alternative plans for balancing the budget before the end of the current fiscal year, which ends June 30, 2013. Spokeswomen for LePage and Health and Human Services Commissioner Mary Mayhew couldn’t be reached to answer those questions late Friday.
Mayhew is scheduled to update the Legislature’s Appropriations Committee on the Medicaid request on Sept. 7.
Sen. Richard Rosen, R-Bucksport, who chairs the Appropriations Committee, said Friday it’s too early to know what the impact of a delayed decision will be.
“We tried to be quite conservative and fairly careful in the amount of savings booked associated with the initiative,” said Rosen, who backed the Medicaid cuts in question. “Once there’s a decision — let’s say it’s a positive decision and they agree to approve the request and the implementation is delayed — at that point you’re able to run an analysis and determine whether you’re able to achieve the same level of savings.”
Either way, Rosen said, a supplemental budget package is likely at the beginning of a new legislative session in January, “even if it’s just for making minor adjustments.”
When the LePage administration submitted its waiver request, it asked the federal government to pay Maine’s state share of Medicaid expenses while it considered the request, if it wouldn’t be able to make a decision by Sept. 1.
The letter from the federal government issued Friday made no mention of that request.
Attorney General William Schneider has promised legal action against the federal government if it doesn’t grant Maine’s request to scale back Medicaid services.
It is not at a stage, whether, it is legal or illegal to make these cuts, the shrewd fine reality is, people will suffer, both by not being treated, or running bills they cannot pay.
If they run bill they an’t pay then they will not be treated. Hospitals don’t let people run up big bills.
They can turn someone away who as an outstanding debt.
Well okay Governor, you were right.
For whatever the reasons may-be *, this supports that it might be very true that in your personal experience people like you do not get much respect from those outside of the State of Maine.
When he is right, I’ll say it.
* “The LePage administration submitted its request for the Medicaid plan amendment on Aug. 1 and requested an expedited decision, by Sept. 1, so the state could implement the Medicaid cuts by Oct. 1. Since the federal government is allowed 90 days to rule on the amendment request, Maine should have a decision in hand by the end of October, well after the cuts were to have taken effect.”
Predicatabe, no action until after the election as they need protection for the Democrats.
That is what the media does best.
The media has absolutely nothing to do with this.
Decision by the end of October, the election is the first Tuesday in November, or November 6th to be precise.
And when I went to school November followed October.
Not until after the election. The Fed’s are all waiting to see if they have a job.
“Maine should have a decision in hand by the end of October.” Pretty sure the election is in November…
Should…lol
Which is why the answer will come mid November.
The people making the decision are midlevel bureaucrats not affected by the election.
And you don’t think something like this will not have to be approved all the way up the chain? We’re talking something that will affect all States if approved or disapproved.
I’d hate to be someone whose life depended on ongoing medical care but who is on LePage’s hit list.
any one of us who do not make 2ook a year are on his list.
its 200% of the poverty level, not 200K a year. 200% of the poverty level in maine for a single adult is around $22,340 a year. Not that I agree with his plans, just lets keep the facts straight.
http://www.mejp.org/medicalprograms.htm#chart
To put some perspective to it, a person working 40 hours a week earning the minimum wage ($7.50 in Maine) makes $300 a week, or $15,600 a year. This person likely does not receive any benefits (health insurance, paid sick time, holidays or vacation pay, etc.).
I think what junker was referring to is the fact LePage is out to destroy anyone who makes less than 200k a year. He only rolls out the red carpet for his rich cronies and to hell with the rest of us. At least that’s what I think he/she meant.
i am and you know it sucks. i am looking for a lawyer to file a lawsuit
Go Get’m!
Lepage and his cronies should start with their healthcare benefits first, and then let it trickle down.
So if LePage makes the cuts anyways and the Feds tell him the cuts are wrong is LePage going to be held accountable for breaking the law or for not waiting on the Fed to rule on a formal decision? Oh wait never mind, I think I answered my own question here….
Politicians are hardly ever prosecuted for ANY reason, and those that are like Ollie North are used as nothing more than scapegoats. It must be a wonderful life never knowing if your life of lawlessness will suddenly end if someone more important than you deems that it should.
It’s Maine’s budget, not Obama’s or did you even take that into consideration.
and that’s why Maine had to go get permission from the Government?
LePage and Republicans in the legislature passed a budget based on these cuts even though they were warned that they may not be legal. They pinned their hopes on the repeal of the Affordable Care Act in an act of futile desparation that defyed logic. Typical tea party bull headedness.
Try right clicking on the words with a red underline – it denotes a misspelling.
Do you mean things like ” Bangor’s drug drug problem”?
Before you comment, you may want to read Renee Ordway’s comments regarding Bangor’s drug problem. It’s hard for a democrat to admit but the welfare problem is very tied into the welfare problem. Maybe if we make it a little more difficult on these losers to live, they will move on. And I don’t feel sorry for any of the druggies terrorizing Bangor’s streets.
Soooo we ruin every recipients life to get at a few abusers. Where’s the logic in that?
The economy is why there is so many who need help.
Don’t put everyone into the same category. Bad apples exist, but not everyone who needs help is a ‘loser’.
This is another lost cause it appears.The gov. and reps. might have jumped the gun a little early.I wonder if this idea was thought up in a brew pub with the chosen few like the last one about the special session.Nothing good ever comes out of booze fueled ideas.
LePage doesn’t carry much weight on the Federal level. He can hurry up and wait. Tough medican for his ego to handle.
He carries far more weight than is healthy for a man his age!
Time for a New Governor…
good the feds arent taking his krap good good good
Attorney General William Schneider has promised legal action against the
federal government if it doesn’t grant Maine’s request to scale back
Medicaid services.
Ohhhhh…….I bet the Feds are shaking in their boots about that!
Which part of “NO” does LePage and his cronies not understand? He has tried this once before already and Kathleen Sebelius told him then that he can’t make those kind of cuts to Medicaid. Does LePage really think his tantrum will make the rule of law magically disappear?
Not only is this ping pong game wrong, LePage & his cronies led this battle that really impacts Maine’s most vulnerable people, elderly and disabled citizens. Look around see in the face of our elders years of hard work, raiding family, working the farms or laboring in our once thriving factories or manufactoring establishments. Today, they live most modest lives and many need our help with fundemental survival things like food, housing assistance, transportation and medication. Yet instead of thanking them for their efforts for us, this Administration kicks them to the ground. HHS send the Maine Legislature and Governor LePage a strong message to go back to the table and do the right thing for this State’s most in need.
Penny, I heard Gov. LePage speak at the State Republican Convention in Augusta. He wants to help the Elderly, the children and the disabled. All the others need to go to work. If you are 19 and not in school, get a job. We all had to start at the bottom. The trouble is, the kids today want what it’s taken their parents years to obtain. He has not kicked anyone to the ground; we all have to tighten our belts. It’s not the responsibility of the government to take care of us. We have become a groveling group of individuals who believe we are entitled to “stuff”. I see it every day where I work. These people have tattoos, smoke cigarettes and have very expensive cell phones. I’m tired to being told I have to “take care” of these people. I like what the Governor is doing. It’s about time.
You speak in mixed statements. I do not doubt that you listened to him speak at the convention; however his actions and those of his followers are contrary to his speak. I do not disagree with you about “starting from the bottom.” I hope no one would argue that point. I speak to people who are unable to work the truly disabled and the elderly. Please understand and stay on point. The Governor and his fellow Republican Legislators did indeed take aim at Maine’s elderly and profoundly disabled. They are the chosen ones to suffer from his/their actions (I speak the truth). I invite you to look up the budget results before you repeat what he said because his actions do not mirror his words. I do not suggest taxpayers take care of those who can do for themselves, just those who can not of which Maine as having the oldest population in the Nation has plenty. Surely, you are agree, helping those who are most vulnerable is just.
It is just.
Penny, again, I have no problem with the elderly and the disabled and children. My issue are the 19 and 20-year-olds that are able-bodied but just don’t work. My goodness, what on Earth did we do before the Welfare program? It’s not “just” to take from me and “give” to someone who does not deserve it. That’s stealing. You have families that go generation to generation on the system and it’s got to stop. It’s not sustainable. Where do you get the money from? Years ago, if you were 19, you just didn’t get it UNLESS you had some sort of disability. It’s gotten out of hand. They use the emergency room like their doctor’s office and when they go to the drug store, they can’t pay the $3 copay for their medication, but walk out with a 12-pack of beer. I’ve seen it. I have to pay my co-pay or else I can’t have my medication. But the “others” can have it no matter what. We have to get our jobs back in the US and once you have more people working, there will be more money to put into the system. I take care of my family and my elderly mother-in-law. That’s what I’m supposed to do. It’s just not up to the government to take my money and give it away. I’m just sick of it. And I’m especially tired of people thinking that this is the wrong attitude to have. When people on the system begin acting more responsibly, then perhaps I”ll change my mind. For now, we have to cut and people need to take care of each other.
Well said!!
I agree.
They knew they were playing with fire and persisted in their wrong-headed policies. Trouble is, not only they but all of us are going to get burned. Malfeasance and abuse of office.
How does it feel Gov. LePage? Now you will know how it feels to those that need a fast response from government!! And then what if your request is not granted. Then you will know how the actual people that need the services feel.
Hallelujah!
You people crack me up. How much more do we have to be taxed? Why do I have to keep working to support people who don’t? Why do I have to work to support all their children that they decide to have. I had to plan my life and I took care of myself and my family. I hope Mr. LePage exercises his 10th Amendment Rights and tells the government to pound salt. We have become a huge country with our hands out and that includes the states. I applaud Mr. LePage for standing up and doing what’s right. It’s not up to me to “take care” of people who refuse to work and are perfectly capable of doing so. I don’t usually read the BDN because of is bias to the left. On this particular article, however, I had to voice my opinion.
I have worked in health care industry for past 12 years and interact with many health care providers on a daily basis. It is WITHOUT A DOUBT that Maine’s Medicaid system (MaineCare) is well known to be one of the easiest to qualify for and abuse. The average citizen of this state has NO IDEA just how comprehensive of a prescription plan/formulary that every MaineCare recipient has access too. Full time employees with full coverage health care provided by their own employer have NOWHERE near as thorough health care plans as MaineCare patients. The drug formulary alone that is accessible to MaineCare patients makes full coverage Anthem/Blue Cross, Aetna, Cigna and United commercial and Med-D prescription plans pale in comparison.
To rub salt in the wound MaineCare patients are charged a nominal and OPTIONAL monthly copay of $3. If they say they cannot pay it the $3 fee is waived. It is routine that the $3 copay is waived by the pharmacist at the back counter of the store only to see the MaineCare patient head to the front register and purchase beer and cigs. This is not conjecture – it is fact.
Our system is long overdue for a major overhaul. Government handouts for many, paid for by few.
Well said!
Surely, BDN, you must have at least ONE photo of our good governor that does not make him look like a buffoon… treat him fairly.
Thank you BDN for putting a good-looking picture of LePage on this article, it must’ve been tough.
He looks a little like Colbert’s canned ham Karl Rove , nonetheless.
Once again, Mr. LePage, please stop attempting to balance the budget on the backs of the elderly and disabled, and lying about it. Maine’s most vulnerable citizens need our protection, and regardless of how many lies you tell or how hard you attempt to cover it up, you and the Legislature are still targeting those who are elderly, or physically or mentally disabled.
Cuts to services are affecting the essential daily needs of these people, whether it’s for daily care, incontinent supplies, food, or medical services.
Our most vulnerable citizens need us to speak for them since they cannot speak for themselves. If you have a family member, friend or relative who is under the care of an agency that receives funding from Mainecare for ANY services or supplies, whether it’s a group home, nursing home, boarding home, etc. you should start questioning their long term caregivers (NOT the administrators) about how the cuts in services are affecting the people under their care. We are reverting to the place we were before the laws were changed to protect those people, with underpaid, untrained staff, minimal supervision of licensing standards, and previously available services now gone. It’s not a far step from where they are now to the substandard warehousing that people fought so hard to stop in the 70s and 80s.
It’s time for the consent decrees that were federally mandated and supervised to be re-opened and re-examined. The judges who were in charge of ensuring that the mandated services were in place will find that what they saw when the cases were closed is not what is in place today. The blame for the substandard services can be laid squarely on the shoulders of Mr. LePage and his cronies, who have all their perks and benefits paid for by the taxpayers, including their gold-plated healthcare, their beautiful homes and their gourmet meals.