The LePage administration is rejecting applications for Medicaid from people who became newly eligible for the program under an expansion approved by voters last fall, according to documents and a progressive advocacy group that is suing the state.
Maine has so far refused to expand the health insurance program, which primarily serves low-income residents, even though voters approved the expansion 59 percent to 41 percent in November 2017. Mainers could legally begin applying for coverage July 2, and the state had 45 days to deny or approve enrollees.
Robyn Merrill, executive director of Maine Equal Justice Partners, a nonprofit that advocates for low-income people, said Tuesday that the organization is aware of several people who have received denial letters from the Maine Department of Health and Human Services, and doesn’t know of any who have been accepted for coverage. Jack Comart, the organization’s litigation director, said a DHHS attorney informed him that the agency would be sending out denial letters.
Gov. Paul LePage has blocked implementation of Medicaid expansion by vetoing a funding bill passed by the Legislature. The state also missed a deadline in the voter-approved law for filing an expansion plan with the federal government.
Maine Equal Justice Partners has sued the administration, maintaining that the law requires the state to implement Medicaid expansion. A Superior Court judge ruled in favor of the organization, but the state appealed that ruling and a decision is pending at the Maine Supreme Judicial Court.
One of the DHHS denial letters, dated Aug. 6, was sent to a Caribou man, informing him that he is “not in a coverable category and is not eligible for full Medicaid coverage.”
Merrill, whose organization played a key role in supporting the 2017 referendum, said it’s against the law to deny coverage by not implementing the expansion.
“They are in violation of the law,” she said. “We plan to take all steps necessary so that Maine people can access health care sooner rather than later.”
Emily Spencer, a DHHS spokeswoman, declined to comment Tuesday, citing the pending lawsuit.
The Caribou man who was denied Medicaid told the Portland Press Herald that he applied in early July through healthcare.gov, the website that helps people apply for coverage under the Affordable Care Act, and was sent an automatic notice that he qualified for Medicaid. The man, who didn’t want to be identified, said he earns less than $10,000 a year as a self-employed web developer, so he should qualify for Medicaid. He said he filled out further paperwork, was rejected, and now he’s worried about being able to afford his cholesterol medication and doctor’s appointments.
‘THIS WHOLE THING IS A MESS’
Ann Correia, 56, of Bangor, said she signed up for Medicaid, but she hasn’t heard whether she’s been rejected or approved. Correia said she’s an uninsured self-employed graphic designer who earns about $6,000 per year, and she recently took on $28,000 in hospital debt when she went to an Orlando, Florida-area hospital this spring with a severe throat infection.
Correia said she needs health insurance but isn’t holding out much hope that her application will be approved, knowing that the LePage administration has been fighting the expansion.
“I should qualify. This whole thing is a mess,” Correia said. “I’m just disappointed that unfortunately we’re not expanding because of state and federal politics.”
About 70,000 Mainers would be eligible for Medicaid under expansion, including low-income childless adults and parents who were previously ineligible for coverage.
Mainers who are newly eligible under expansion can be earning up to 138 percent of the poverty level, or about $34,600 for a family of four. Those who earn slightly more than that can obtain inexpensive insurance through the Affordable Care Act individual marketplace.
About 273,000 Mainers currently have Medicaid, a federal program operated by the states. Ninety percent of the cost of Medicaid expansion is funded by the federal government, and Maine would draw down more than $500 million annually in federal funds to pay for health coverage. Medicaid operates in Maine under the name MaineCare.
CONSISTENT OPPOSITION
Maine Equal Justice Partners encouraged people to apply for Medicaid, but it’s not known how many have done so. About 700 had used the nonprofit’s online screening tool by mid-August to see if they were eligible, Merrill said, and presumably others tried to sign up in other ways.
LePage has consistently opposed Medicaid expansion, arguing that it would be financially disastrous for the state. In June, he said the Legislature’s $60 million funding bill contained “unsustainable budget gimmicks,” and he vetoed it. LePage also tightened Medicaid eligibility requirements in 2013, making it more difficult for childless adults and parents to qualify.
The expansion would reverse the LePage-era Medicaid rules, and expand eligibility even more.
Merrill said if eligible people who applied were denied after an administrative appeal, Maine Equal Justice would file a separate lawsuit on their behalf.
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