AUGUSTA — Saying it’s caught in a catch-22 of federal requirements, the Le-Page administration formally asked the federal government on Wednesday to allow cuts in Medicaid programs that the Legislature included in Maine’s budget-balancing law this spring.
The cuts, due to take effect Oct. 1, eliminate Medicaid coverage for 19- and 20-year-olds, remove 1,825 people from the Medicare Savings Program, and increase eligibility requirements for non-disabled, non-pregnant adults on Medicaid. The reductions altogether save $20 million.
While the cuts were difficult for the Legislature to make and won’t be easy for people losing coverage, “they are necessary for Maine not only to meet its constitutional obligation to submit a balanced budget” but also to reduce the growth of Medicaid spending the future, state Health and Human Services Commissioner Mary Mayhew said.
The state’s request, filed with the federal Office of the Centers for Medicare and Medicaid Services in Boston, says Maine’s eligibility standards in Medicaid, even with the cuts, still exceed federal minimums. It also points to a U.S. Supreme Court decision in June that says Medicaid expansions under the federal health care overhaul law cannot be forced upon the states.
Maine had voluntarily agreed to expand Medicaid benefits, paid for with federal stimulus funds, through mid-2011, state officials say. But the national health care law froze those Medicaid standards, in effect making a voluntary program mandatory without extending funding, state Attorney General William Schneider said.
“We were caught in a catch-22 as far as our ability to make changes” in Medicaid eligibility, Mayhew said. With the Oct. 1 date for changing eligibility standards drawing closer, the state is asking for expedited approval of its request.
Republican Gov. Paul LePage has said that Medicaid, known in the state as MaineCare, has grown well beyond state taxpayers’ ability to pay for it and is in need to scaling back. The administration says the program currently serves 361,000 residents, and that if enrollment tracked with the national average, it would be 260,000.
If the federal government turns down Maine’s request to go ahead with those cuts, “we’ll likely have to file a case in court,” Schneider said.
Legislative Democrats, who opposed the cuts since they were first proposed before the Appropriations Committee, said they would affect 26,500 people.
Democratic Sen. Dawn Hill of Cape Neddick, a member of that committee, said the governor “has manufactured a budget crisis and the truth is that we have other options for how to balance the budget besides taking away health care.”
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