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January 4, 2019

Mills calls on feds to 'promptly approve' Medicaid expansion for 70,000 Mainers

Courtesy / Office of the Governor
Courtesy / Office of the Governor
Gov. Janet Mills signed her first executive order on Thursday, which directs the Maine Department of Health and Human Services to swiftly and efficiently begin implementation of Medicaid expansion approved by Maine voters in November 2017, but repeatedly blocked by Gov. Paul LePage during his final year in office.

With the stroke of her pen on Thursday, Gov. Janet Mills signed her first executive order, which directs the Maine Department of Health and Human Services to swiftly and efficiently begin implementation of Medicaid expansion approved by Maine voters in November 2017, but repeatedly blocked by Gov. Paul LePage during his final year in office.

In doing so, she fulfilled a campaign promise and set into motion expansion of MaineCare to provide Medicaid coverage to more than 70,000 Mainers.

Mills also sent a letter Thursday to U.S. Secretary of Health and Human Services Alex Azar and Administrator of the Centers for Medicare and Medicaid Services Seema Verma requesting the formal approval of the "state plan amendments" filed by the LePage administration and amended by her executive order.

"More than a year ago, the people of Maine voted to expand Medicaid," Mills said in a statement sent to Mainebiz on Thursday. "Today, my administration is taking the long-awaited steps to fulfill their will. I am directing my administration to begin implementing Medicaid expansion as quickly and as efficiently as possible so that we can help more Maine people access the health care they need. Expanding health care and lowering the cost for Maine people and small businesses is a top priority of my administration, and I look forward to working with the Legislature to achieve that goal."

In her letter to Azar and Verma, Mills underscored the support shown by 59% of Maine voters for Medicaid expansion and asked them to "promptly review and approve" the state plan amendments her administration has submitted with an expansion effective date of July 2, 2018. She expressed her hope they would do so as has been done "for 35 other states and the District of Columbia."

"As you know, approval of Medicaid state options is not contingent on the sources of state funding, and, even if it were, general revenue funding to initiate expansion of Medicaid exists," she wrote in her letter. "Therefore, it is our responsibility to move Medicaid expansion forward. I am committed to working with the Legislature to ensure the sufficiency and ongoing funding of the expansion."

What comes next?

Jeanne Lambrew, who's been nominated by Mills to be the commissioner of the Maine Department of Health and Human Services, described Thursday's executive order as a "critical first step" in achieving the mission of safeguarding the "health and well-being of Maine children and families."

"Full implementation of Medicaid expansion will take time and the collective cooperation of our health system, but with Gov. Mills' leadership, access to affordable health care coverage for Mainers is now on the horizon," she said in a news release.

Here's what the executive order initiates:

  • It directs the Department of Health and Human Services to make changes to process the applications of Mainers seeking health care coverage under Medicaid expansion, including amending the filings of the previous administration to reflect the accurate date of implementation (i.e. July 2, 2018) and to seek the earliest possible approvals as allowed under the expansion act. Under the order, the Department will adopt all rules as established in the Expansion Act before the Feb. 1, 2019, deadline ordered by the Superior Court.
  • It directs the DHHS to partner with health care providers, organizations, patients, patient and consumer representatives and other stakeholders to create and implement a communications and outreach strategy to help enroll eligible Mainers, with a primary goal of speeding up application processing time and eligibility determinations to provide coverage as quickly as possible.
  • It directs DHHS to work with the state Legislature to identify sustainable sources of funding for Medicaid Expansion to ensure eligible Mainers receive health care coverage under the Expansion Act in both the short- and long-term.

The state's first full-year cost of expanding Medicaid is about $31 million to $55 million, according to healthinsurance.org, while the federal government will contribute about $490 million to $525 million.

Last July LePage vetoed a bill that would have provided about $60 million in funding for the first year of the program, while also covering the cost of adding 110 workers to the Department of Health and Human Services staff to help manage cases in an expanded program. It was the sixth time LePage vetoed a Medicaid expansion bill passed by the Legislature.

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