20-05-2025
Maine House fails to garner enough Republican votes to make Medicaid funding available sooner
Several legislators said that they've heard concerns from constituents, both those who work in the health care field who are worried about layoffs and those who rely on Medicaid worried about accessing services. (Photo by Getty Images)
As health care providers warn of depleted funds hampering services, the Maine Legislature appears poised to close off a path that would make already allocated Medicaid funding available sooner.
With a 93-50 vote on Tuesday, the Maine House of Representatives failed to reach the two-thirds support needed to enact an emergency measure.
The contents of this bill are already law. The funding was included in the two-year budget passed in March. What's new is that this bill would make that funding available immediately.
Democrats pushed through a two-year budget that continued government spending at the same level but also included additional funding to address emergency needs, notably to address a $118 million funding deficit for MaineCare, the state's Medicaid program.
However, because that budget bill also failed to garner the support of two-thirds of the Legislature, the funding will not be available until late June.
The Democratic majority moved ahead with that plan without GOP support after Senate Republicans refused to support an earlier change package for the current fiscal year to address the MaineCare deficit and other urgent needs unless it included structural reform to the health care program.
Legislative leadership accepted a late-submitted emergency bill, LD 1948, as a way to try to get the funding out to providers sooner.
'This bill before us here is just the blank check part without the other reforms that we had agreed to,' House Minority Leader Billy Bob Falkingham (R-Winter Harbor) said ahead of the vote on Tuesday.
However, not all members of the minority party felt the same way. Rep. Rachel Henderson (R-Rumford) voted against the supplemental budget because at the time she'd felt that there was an opportunity to push for reform, but she said on Tuesday that the measure before the body was different.
'Now what's before us is, we're asking ourselves, do we want to pay our bills?' Henderson said. 'I would urge my colleagues, let's let the past be the past.'
Despite not clinching the support needed, the bill will still head to the Senate for enactment and could return to the lower chamber if the emergency threshold is reached in the upper chamber.
The state started withholding some payments to health care providers on March 12 amid the budget debate to ensure some level of funding would be available for the duration of the current fiscal year. Several hospitals said then that they were not in a position to absorb the payment cuts.
Now, the total withheld to community-governed hospitals in the Maine Hospital Association is approaching $100 million, Jeffrey Austin, vice president of government affairs for the association, told Maine Morning Star.
'This is a lot of cash to not have available to pay bills with,' Austin said. 'Maine hospitals have some of the lowest margins in the country and the highest debt.'
The load hospitals bear gets heavier with each day that goes by without a full restoration of reimbursements, Austin said.
'It's made a tough situation that much tougher,' he said, 'and the sooner it's over the better.'
Several legislators said on the House floor Tuesday that they've heard similar concerns from constituents, both those who work in the health care field who are worried about layoffs and those who rely on Medicaid worried about accessing services.
'So when I'm asked, 'What's in it for us?'' Rep. James Dill (D-Old Town) said. 'The answer is simple: people.'
Hearing similar concerns in his district, Rep. David Rollins (D-Augusta) acknowledged LD 1948 won't fix all of the financial challenges providers are currently facing, 'but it will provide some relief by ensuring that the providers get the MaineCare funding they're owed by the state.'
Speaking with Maine Morning Star, Scott Hanson, president of the Maine Medical Association, which represents the state's physicians, residents and medical students across all clinical specialties, had a similar view of the emergency legislation. While noting challenges with hiring and retention and what he sees as inadequate reimbursements rates, Hanson said MaineCare payments are a crucial part of providers' bottom lines, so having that funding restored sooner is a priority for the association.
Regardless, Hanson is concerned about the state of Medicaid, given possible cuts coming from the federal budget being considered by U.S. Congress.
'Things are so, how shall we say, topsy turvy, or uncertain coming out of Washington,' as Hanson put it.
The U.S. House of Representatives Committee on Energy and Commerce, which oversees health care, approved a bill last week that proposes the largest cuts to Medicaid in the history of the program. The full House is expected to vote on the package this week and, if it passes, it would then head to the Senate, where GOP lawmakers are expected to rewrite numerous sections of the bill.
'That's going to trickle down to the states as a lack of funding,' Hanson said. 'So it could make the current crisis for Augusta legislators a whole lot worse.'
The two-year budget Democrats passed in March did not include any policy changes to address the sizable budget deficit the state faces over the next biennium, including another expected shortfall for MaineCare. Gov. Janet Mills' proposals to close that gap — tax increases and program cuts — as well as the requests from the public and lawmakers are being considered for the next iteration of the budget plan.
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