Mainers for Health Care rally outside the State House prior to Gov. Paul LePage's State of the State address, Tuesday, Feb. 13, 2018, in Augusta, Maine. Credit: Robert F. Bukaty | AP

AUGUSTA, Maine — Gov. Paul LePage’s administration is not saying whether it will provide Medicaid coverage for low-income residents who have applied while a legal battle over Medicaid expansion continues.

Mainers who sought Medicaid expansion under a voter-approved law last month could receive coverage as early as Thursday or Friday. Nearly 3 out of 5 Mainers last November approved a law to expand Medicaid to as many as 80,000 low-income residents. Under another state law, Medicaid applicants become entitled to full coverage if Maine doesn’t decide whether individuals are eligible within 45 days.

Officials in LePage’s administration have declined comment on the deadline, citing the ongoing litigation. Since May, the governor has not sent lawmakers legally required monthly reports detailing the state’s progress in rolling out Medicaid expansion.

Advocates who sued to force Maine to roll out Medicaid expansion anticipated that the administration will deny coverage to the applicants. Maine’s high court will weigh in soon on whether LePage’s administration must take the next step of seeking federal funding for expansion.

The governor has warned that his administration could simply deny Medicaid applications they don’t have time to review. Lawmakers have not passed funding for an estimated 100 new staffers needed to handle such applications.

“We have to avoid putting the state on the hook for medical bills of potentially hundreds and even thousands of people,” LePage said in June.

Advocates sued after LePage failed to meet an April deadline to file the paperwork required to request an eventual $525 million in annual federal funding for Medicaid expansion.

The voter-approved Medicaid expansion law doesn’t include a way for Maine to eventually raise about $55 million in annual state funding for expansion, and critics say that’s made the ongoing legal battle inevitable.

“We’re in uncharted territory here,” said Terry Brown, communications director for the Maine Heritage Policy Center, which opposes Medicaid expansion. He later added: “People go into the ballot box and vote for something. The government is left asking: How are we going to fund it?”

Advocacy group Maine Equal Justice Partners has been encouraging Mainers to sign up for expansion, and claims it’s helped about two dozen apply so far. The group and other expansion supporters say the state could retroactively seek reimbursement from the federal government for new Medicaid enrollees, and that the state has enough Medicaid dollars to cover its share of the first year of expansion: an estimated $30 million after savings.

“We expect that denials are going to be coming,” said Maine Equal Justice Partners Policy Analyst Kathy Kilrain del Rio.

But the LePage administration’s refusal to follow the voter-approved law could jeopardize federal funding for new Medicaid recipients under expansion, she added. The group could file another lawsuit if the administration keeps delaying expansion, she said.

“There’s obviously urgency, people’s lives are literally on the line,” she said.

The governor denies that expansion will immediately save Maine money, says Medicaid costs will rise exponentially and has called for lawmakers to come up with a “sustainable,” long-term plan to fund its share of Medicaid expansion. LePage successfully vetoed lawmakers’ plan to set aside surplus funds and one-time tobacco-settlement funds to ensure Maine has enough money for its share of Medicaid expansion.

The governor recently said he’d rather go to jail than jeopardize the state’s finances by expanding Medicaid.

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