Maine Gov. Paul LePage, R (Governor's office photo/Jim Bowdoin)

AUGUSTA, Maine (AP) — The Maine House on Monday approved a bill to expand the state’s Medicaid program to include roughly 70,000 more people.

The bill would tap federal Patient Protection and Affordable Care Act (PPACA) Medicaid expansion funding.

Representatives voted 89-51 for the bill Monday, adding changes aimed at mitigating worries of Republicans who’ve opposed expansion in past votes. The amended version says the state can opt out of the Medicaid expansion if the federal government fails to live up to its promises to cover most of the cost of the added Medicaid spending. The bill faces a Senate vote as early as Tuesday.

Last week, the U.S. Department of Health and Human Services (HHS) confirmed it will pay 100 percent of the cost of expansion for the three calendar years starting in 2014, reaching 90 percent in 2020. But minority Republicans have remained concerned about potential expense to the state despite government promises, saying it will cost $400 million in Maine taxpayers’ money in the seven years after the first three-year full-coverage period.

Republicans also say expansion will not help 3,100 seriously disabled Mainers who are on waiting list for Medicaid services. Medicaid is administered as MaineCare in the state.

Rep. Richard Malaby, R-Hancock, told lawmakers during Monday’s debate that a health care exchange, to be in service this October as part of PPACA, will offer low-cost health care coverage opportunities for those who would otherwise be covered through the expansion. Malaby described MaineCare as a “financially failed program” and said it makes no sense to expand it “with all of its inherent risks.”

But supporters of expansion said it will fill a large gap in the number of Mainers who get health coverage.

“We have the opportunity to provide for 70,000 of our neighbors the benefits of preventive care for their health, that we in this chamber all enjoy,” said Rep. Drew Gattine, D-Westbrook. “We have the opportunity to inject Maine’s economy with over $250 million in economic stimulus and create more than 3,100 new jobs. We have the opportunity to lighten the burden charity and uncompensated care have on our providers, especially hospitals, and on consumers who ultimately pay for that care.”

In addition to creating thousands of health care-related jobs, the bill will free up money for education, infrastructure and public safety, said Assistant House Majority Leader Jeff McCabe, D-Skowhegan.

By adding the “opt out” provision to the bill, majority Democrats lured more Republicans behind the Medicaid expansion, in hopes of lining up enough support to override a potential veto should the bill reach Gov. Paul LePage’s desk.

LePage issued a statement saying he will not discuss expansion of Medicaid until 3,100 disabled and elderly people on waiting lists “are taken care of,” and fraud and abuse in the social service system are addressed.

“Until we crack down on the fraud and abuse that robs hard-working Mainers of their tax dollars, I will not discuss any efforts to expand welfare,” LePage said.

The Republican governor has already vetoed a more sweeping bill calling for Medicaid expansion, even though it included a provision to repay the state’s hospitals $484 million in past debts for unpaid Medicaid services, a major priority for LePage. The Maine Senate sustained the veto.

See also: