AUGUSTA — Both houses of the Maine Legislature have voted to approve funding to extend Medicaid to an estimated 70,000 residents, potentially undercutting Gov. Paul LePage’s argument against implementing the voter-approved expansion.

In a separate action Wednesday, the Maine Supreme Judicial Court granted LePage’s request to stay a lower court’s order that would have required him to immediately submit an expansion plan to the federal government.

In Augusta, the Senate and House agreed on a plan to pay for the state’s estimated $60 million share of costs associated with Medicaid expansion in Maine and sent the bill to LePage’s desk.

In November, voters approved expanding Medicaid by a margin of 59 percent to 41 percent. The expansion will open up the program to Mainers who earn 138 percent of the federal poverty level – $16,753 for an individual or $34,638 for a family of four. The change would expand the system to an estimated 70,000 Mainers, although critics of the expansion say it could increase the state’s Medicaid rolls by as much as 80,000.

REALIGNING FUNDING SOURCES

LePage has repeatedly blocked Medicaid expansion through legislation, and after voters approved it in a referendum he has refused to implement it, arguing that the Legislature must first allocate funding.

There are conflicting assessments about how much the expansion will cost the state even with the federal government footing 90 percent of the bill. A recent study funded by the Maine Health Access Foundation estimated it will cost roughly $30 million in the current two-year budget, but the LePage administration has pegged the costs at $60 million during the first year and as much as $100 million annually in future years.

While both houses support a roughly $60 million allocation if needed, the Senate voted 23-9 Wednesday to amend a bill approved Tuesday by the House. The amendment calls for funding the expansion using $31 million in surplus funds and up to $23.5 million of the additional money that the state received from a lawsuit settlement with tobacco companies, and excludes the proposed use of about $20 million from the state’s budget stabilization account, known as the “rainy day” fund.

The bill also would allow LePage or the next governor to tap further into the tobacco settlement fund if it was needed to cover the costs of the new enrollees that LePage foresees.

The governor has made clear his opposition to using money from the rainy day fund, and his spokeswoman, Julie Rabinowitz, reiterated Wednesday the other expansion criteria that LePage had communicated to lawmakers in December.

Among them, the governor has said he will allow expansion to move forward only if it does not increase taxes on Maine families or businesses, if it doesn’t use one-time funding sources or “gimmicks,” and if the Legislature first provides full funding to eliminate waiting lists for hundreds of disabled and elderly Mainers who are currently seeking state services and help. Since taking office in 2011, LePage has successfully vetoed expansion bills five times and has frequently argued that the state cannot afford to expand Medicaid, pointing to previous budget deficits that were largely generated by cost overruns in the state’s Medicaid program.

Rabinowitz, in an email to the Portland Press Herald, noted that the Legislature had more than six months to identify a funding source for the expansion but did not do so. She also raised an argument that LePage has made in the courts that even if the funding for expansion comes, his administration would be unable to hire the additional staff needed to process new enrollees starting July 2, the date set in the November referendum.

Rabinowitz also referenced the Supreme Judicial Court’s decision to grant LePage a short-term stay on the lower court’s order requiring him to submit an expansion plan while it takes up his appeal of that decision, which has not been scheduled for oral arguments.

FUNDING VOTE, LEGAL RAMIFICATIONS

In an appearance Wednesday morning before the Portland Regional Chamber of Commerce, LePage restated his objections to expanding Medicaid, saying it needs to be funded before his administration will implement it.

“Medicaid expansion, it is the law, but we need to adequately fund it,” LePage said, predicting that without adequate financing, hospitals will be left holding the bag.

LePage has argued to the courts that as governor, he can’t appropriate the money for expansion because that’s a responsibility of the Legislature, and without the money the expansion can’t proceed. Wednesday’s legislative action could undercut that argument.

It remains uncertain whether LePage will veto the expansion funding measure when it gets to his desk. A veto would likely be sustained by minority Republicans in the House. LePage will have 10 days from the time he receives the funding bill to make a decision.

The tobacco settlement money came indirectly from the office of Maine Attorney General Janet Mills, who was announced Wednesday evening as the winner of the Democratic primary for governor after tabulation of the ranked-choice votes. Mills said in April that her office and attorneys general in eight other states had reached an agreement with tobacco companies that would result in an additional $35 million for Maine as part of a 1998 legal settlement with the industry.

CALL FOR LEPAGE TO MOVE FORWARD

Robin Merrill, executive director of Maine Equal Justice Partners, which advocates for the poor in Maine and backed the November referendum, said now that the Legislature had found a way to finance the expansion, LePage needs to move forward and enforce the law as approved by voters. Merrill also said LePage’s cost estimates for expansion do not factor in any savings the state would see in its Medicaid programs because of the 90 percent match from the federal government.

“There was a very strong bipartisan vote by the Senate today that effectively gives the governor the money he claims he needs to implement the law the voters passed,” Merrill said. “The Legislature is doing its job and it’s time for the governor to do his job. No more excuses.”

Scott Thistle can be contacted at 713-6720 or at:

sthistle@pressherald.com

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