Maine wants 10-year guarantee on Medicaid expansion

AUGUSTA, Maine (AP) — The administration in Maine is asking the federal government to pick up 100 percent of Maine’s costs of expanding Medicaid for 10 years, if Maine is to agree to the expansion through the Patient Protection and Affordable Care Act (PPACA).

“We need a longer-term commitment and greater support from the federal government in order to move in the direction of expanding Medicaid,” Maine Health and Human Services (HHS) Commissioner Mary Mayhew said Wednesday, two days after making the request to her federal counterpart, U.S. HHS Secretary Kathleen Sebelius.

Mayhew’s letter was sent as Gov. Paul LePage, R, considers whether to expand Medicaid — known in the state as MaineCare — under PPACA.

LePage has resisted expansion in the past out of concern that the state may not be able to meet its long-term obligations from expansion. Mayhew said the state faces a $270 million hole in its two-year budget as a result of increased costs in Medicaid and the latest reduction to the federal reimbursement rate for the program that helps pay for health care for low-income people.

But LePage’s opposition has softened in recent days; he said he would consider it if the majority Democrats act quickly on his plan to pay a nearly $500 million hospital debt.

LePage’s decision to revisit the issue comes as more than half the nation’s governors join the expansion, consider it or look for alternatives. Some other Republican governors have switched positions from opposing expansion to supporting it. LePage’s latest position, to even talk about expansion, drew a poke from conservative online publication “As Maine Goes,” which asked, “Is LePage Turning Democrat?”

Under PPACA, the federal government has offered to pick up 100 percent the cost of Medicaid expansion in the first three years, and 90 percent after that.

It’s the “after that” that worries the administration.