The advocacy group that led the successful ballot-box campaign to expand Medicaid in Maine filed a lawsuit Monday seeking to compel the state to implement the program.
Maine Equal Justice Partners filed the suit in state Superior Court in Augusta, arguing that the failure to expand Medicaid is harming low-income Mainers who by law should be eligible to receive Medicaid insurance this year.
Donna Wall, 61, of Lewiston is one of five Mainers named in the lawsuit who would be among 70,000 to gain Medicaid insurance once the law goes into effect. The lawsuit is an attempt to force Medicaid expansion opponent Gov. Paul LePage to implement the expansion.
“It’s really making me angry,” said Wall, a newspaper carrier who cares for three adult children with disabilities. Wall, who is uninsured, broke her ankle this winter and said she has $64,000 in medical debt. “LePage is taking his sweet time not doing something that should have been done. He needs to follow the law.”
Maine Equal Justice Partners also asked the court to expedite hearings, because the July 2 date when Mainers are supposed to be eligible to sign up for Medicaid is looming. If LePage, a Republican, succeeds in delaying Medicaid expansion through the end of his term, the task may fall to his successor, who would take office in January. Democrats, Republicans and independents are vying to replace LePage this fall.
Jack Comart, litigation director for Maine Equal Justice Partners, said Mainers shouldn’t have to “choose between seeing a doctor and putting food on the table.”
“This lawsuit is about more than groups fighting with the state over the law. It’s about real people who should begin to receive access to health care starting in July,” Comart said.
Although Mainers who are newly eligible for Medicaid should be able to enroll by July 2, the state has taken no steps under LePage, a staunch expansion opponent, to implement the law. If the lawsuit is successful, the court would order the LePage administration to implement Medicaid expansion.
“Due to the failure or refusal of (Maine Health and Human Services Commissioner Ricker Hamilton) to timely submit the required state plan amendment, each and every individual petitioner faces a delay in obtaining medically necessary and potentially life-saving health coverage,” the lawsuit states. The state plan amendment, which should have been filed with the U.S. Centers for Medicare and Medicaid Services by April 3, would have been the first step to launch Medicaid expansion. Maine was one of 19 states that had refused to expand Medicaid until voters approved it at the polls last November, by a 59-41 percent margin.
The law sets deadlines for the Department of Health and Human Services to submit plans to the federal government for expanding the Medicaid program to an estimated 70,000 Mainers who earn up to 138 percent of the federal poverty level, or $16,753 for a single person, $25,100 for a family of four. Medicaid expansion is a key component of former President Barack Obama’s signature domestic law, the Affordable Care Act, and the federal government funds most of the cost of state expansion. Medicaid expansion was originally mandatory for states, but a 2012 U.S. Supreme Court decision gave states the option to choose whether or not to expand.
Joining the lawsuit were five Mainers who would qualify for Medicaid under the expansion, health care groups Consumers for Affordable Health Care and the Maine Primary Care Association, and a health clinic in Bangor, Penosbscot Community Health Care.
LePage spokesman Peter Steele declined to comment, noting that the governor does not comment on pending litigation, but Sen. Eric Brakey, R-Auburn, the co-chair of the Legislature’s Health and Human Services Committee, backed the governor’s refusal to implement the expansion.
“I don’t know how any serious person can expect the governor to implement a huge expansion of welfare without funding,” Brakey said. “This is exactly the problem with these far-left proposals – the money has to come from somewhere.
“Maine Equal Justice Partners didn’t include a funding mechanism in their referendum to give ‘free’ healthcare to able-bodied adults — they just expected the legislature to magically come up with the money.”
LePage vetoed four attempts at Medicaid expansion in the Maine Legislature from 2013-15 that had attracted support from Democrats and moderate Republicans. The expansion was approved by broad majorities, but fell just short of the two-thirds necessary to override LePage vetoes. A fifth attempt at Medicaid expansion died in the Legislature in 2016.
Lawmakers approved an initial $3.8 million expenditure this month to enable DHHS to hire additional staff and cover administrative costs of expansion. However, that funding is caught up in a bipartisan standoff over extending the legislative session to complete work on a number of bills. The full cost of Medicaid expansion is about $45 million in state funds in the first full year of implementation, according to the nonpartisan Office of Fiscal and Program Review, which would grow to about $55 million by 2021.
The expansion would unlock more than $500 million per year in federal funds that would begin flowing to Maine to cover the health care costs of lower-income Mainers.
LePage has insisted that the Legislature fund the program without raising taxes or dipping into the state’s Rainy Day Fund. Maine ended the 2016-17 fiscal year with a $111 million surplus.
LePage tightened Medicaid eligibility in 2013, making it more difficult for childless adults and some parents to qualify for Medicaid. Mainers who had Medicaid insurance declined from 356,000 in 2011 to 268,000 in 2017, partly from the reduced eligibility and also because the economy improved and some people gained employer-based insurance.
House Speaker Sara Gideon said in a statement that the lawsuit is “necessary” because the LePage administration has failed to act.
“Implementation of this law is a responsibility and obligation that needs to be fulfilled. Thousands of Mainers cannot afford to wait any longer for the health care they need to be and stay well,” Gideon said.
The five Mainers who would qualify for Medicaid under the expansion include Wall of Lewiston, Cassie Steimlosk of Raymond, Charles McDaniel of Waterville, Ann Avery of Old Town and Gina Zamello of Oakland. Some of their personal situations were detailed in the lawsuit.
“Gina (Zamello) has multiple medical issues, including a heart condition and a neurological disorder that limit her ability to work and do other activities,” the lawsuit states, noting that Zamello works part time. “She is currently without health insurance, unable to see the heart specialist, and unable to afford her medications.”
Joe Lawlor can be contacted at 791-6376 or at:
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