AUGUSTA, Maine(NEWS CENTER ) -- The Maine Senate on Wednesday took this session's first vote on the controversial Medicaid expansion plan.
The bill passed, but by a smaller margin than supporters wanted. The vote came after a three-hour debate, in which Democrats and Republicans repeated the arguments that have filled the Statehouse for the past several months.
The expansion plan would provide free Medicaid health insurance to Mainers who are not disabled, and earn up to 138% of the federal poverty level (FPL). For a single person, that would amount to roughly $15,700. Democrats say there are about 70,000 Mainers eligible for the expansion. Republicans say the total is closer to 100,000. The two parties also disagree on nearly every other aspect of the proposed expansion.
Most of those covered by the Maine Care expansion would be paid for with federal funds, under the Affordable Care Act, until the end of 2016. At that point federal funding would gradually decline to 90%. The parties in the Legislature cite radically different cost projections for that period.
Under the "compromise" bill voted on Wednesday, which was drafted by Republican Senators Roger Katz and Tom Saviello, the expansion would be accompanied by a gradual shift of Maine's entire Medicaid population to managed care. Katz told fellow Senators during the debate that this would mean several private managed care companies would contract with the state to provide care, paying a flat fee for each patient, instead of the current "fee for service" method, which has caused the Legislature and DHHS officials to be unable to accurately budget annual costs.
Democrats supported the plan, saying it would save the state money, create thousands of new health care jobs, provide urgently needed health care to patients and potentially save lives. Republicans, however, say the current Medicaid program is already unaffordable. They say it consumes 25% of the state general fund budget now, and predict that will grow to 38% of the state budget. Several GOP lawmakers also said Maine should not make more people dependent on state government, and should point them to subsidized private insurance on the health care exchange instead.
Under the ACA, people earning less than 100% of the FPL are not allowed to buy subsidized policies on the exchange.
The bill ultimately passed the Senate, on a vote of 22-13. However, that is less than the two-thirds majority that would be needed to override a veto from Governor LePage. The Governor has promised to veto the bill. The House will vote next, and Senators will get another opportunity as well. Statehouse observers do not expect the bill to get a two-thirds majority in either chamber.
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