Court says Maine must submit Medicaid plan, despite appeal

June 18, 2018 GMT

AUGUSTA, Maine (AP) — A state judge has ordered the LePage administration to file paperwork to expand Medicaid despite an ongoing appeal, and the administration vowed on Monday to fight the order.

Superior Court Justice Michaela Murphy denied a motion filed by Republican Gov. Paul LePage’s administration to delay the process pending an appeal. The administration swiftly appealed to the state supreme court, arguing that the ruling violates the state constitution’s separation of powers.


Murphy said the harm to low-income Mainers left without Medicaid benefits outweighs harm to LePage’s administration. She acknowledged her order could create more litigation and uncertainty.

“The executive branch’s refusal to act and follow the will of the people ... has the potential to engender disrespect for duly enacted laws,” the judge wrote Friday.

Last fall, Mainers approved a referendum aimed at expanding Medicaid by July 2 to over 70,000 adults, but the governor ignored an April deadline to submit a Medicaid expansion plan necessary to get the ball rolling and to receive more than $500 million in annual federal funds.

The administration appeal, filed Monday, argues that the courts can’t force the state to implement “massive new benefits” that state lawmakers haven’t funded.

A lawyer representing Department of Health and Human Services Commissioner Ricker Hamilton on Monday renewed his motion to file the paperwork only if the state’s high court rules in favor of Medicaid expansion supporters. Hamilton’s motion contends that he is not subverting the people’s will. Instead, he argues, Maine’s superior court is usurping the legislative appropriations process.

LePage has long said that before Maine expands Medicaid, lawmakers must fund the state’s share of the expansion cost under his terms, including no tax hikes.

The lawsuit filed by Maine Equal Justice Partners and other groups contends there are enough funds in the state’s Medicaid account to get through the current budget ending in mid-2019. There also is more than $140 million in unallocated funds that the state could draw from at any time, the group said.

The LePage administration declined comment Monday.

Maine lawmakers this week could consider a bill for $3.8 million in state funds to hire about 100 new staffers to roll out Medicaid expansion. Some lawmakers and advocates have been discussing whether such legislation should explicitly set aside surplus funds for Medicaid expansion.


LePage disagrees with estimates that Medicaid expansion will immediately save Maine money, and contends the cost will grow exponentially.

While the LePage administration estimates the first year of Medicaid expansion will cost the state $58 million, separate estimates by an independent firm and the Legislature’s non-partisan fiscal office say that cost drops to roughly $30 million after savings.

LePage vetoed Medicaid expansion proposals five times before voters approved it in a referendum. LePage said he considers Medicaid another form of welfare and has asked federal regulators for permission to require recipients to work and pay premiums.

Maine serves about 268,000 Medicaid recipients, down from 354,000 in 2011. LePage credits the drop to his administration’s tightened eligibility restrictions.