As Maine waffles on Medicaid expansion, residents in limbo

August 20, 2018 GMT

AUGUSTA, Maine (AP) — Maine residents seeking health coverage under voter-approved Medicaid expansion are in limbo as Republican Gov. Paul LePage’s administration refuses to say definitively whether it plans to provide it.

An advocacy group has said LePage’s administration signaled through an attorney that Maine is going to reject people applying for Medicaid expansion. But the attorney, Patrick Strawbridge, said Monday that he couldn’t comment on how the state will handle Medicaid applications.


Strawbridge said cases “will proceed” while Maine’s health agency goes through a decision-making process in the coming weeks. He declined to say whether that means the state will deny or approve applications and said that’s up to the Department of Health and Human Services.

The Department of Health and Human Services declined to comment because of pending litigation to force Maine to seek federal funding for Medicaid expansion. Maine’s high court is expected to weigh in soon.

Nearly three out of five Maine residents last November voted to allow adults under age 65 with incomes at or below 138 percent of the federal poverty line to apply for Medicaid coverage starting July 2. Donna Wall, who cares for her three adult children with autism in Lewiston, said she applied July 3 and received a denial letter a week later encouraging her to buy insurance on the marketplace set up through then-President Barack Obama’s health care law.

“I really feel like it’s not going to happen until we get a new governor,” said Wall, who is appealing the decision.

Maine officials have 45 days after receiving the application to determine eligibility. If they fail to make a decision, applicants receive the coverage by default.

People have 30 days after being rejected to appeal. Advocacy groups are prepared to help, said Robyn Merrill, executive director of Maine Equal Justice Partners, which led the fight for Medicaid expansion and sued along with Wall to force Maine to roll it out.

Merrill’s group released an Aug. 6 letter in which the state informs a Caribou man that he’s ineligible for full Medicaid coverage because he’s not in a “coverable category.”

LePage has said he’d rather go to jail than jeopardize Maine’s finances by expanding Medicaid to 70,000 to 80,000 low-income residents.


Advocates and a non-partisan legislative analyst say that Maine already has enough Medicaid funds to cover the state’s share of the first year of Medicaid expansion. LePage has vetoed legislation to use surplus money and one-time tobacco settlement funds, instead insisting there be a long-term funding plan.

Darcy Shargo, interim CEO of Maine Primary Care Association, which represents community health centers across the state, said ongoing litigation and politics have sowed confusion.

“For individual patients, it creates pretty significant stress,” she said, adding that many people who are trying to sign up for coverage have “fairly complex medical needs.”

“The longer the needs go unmet, the harder they are to address,” Shargo said.