Lobbying the feds on a Medicaid expansion plan may not make much difference

6 years ago

Good morning from Augusta. Since the state submitted a court-ordered Medicaid expansion plan to the federal government along with a letter from Gov. Paul LePage saying it should be rejected, top Maine Democrats have written to argue that it should be accepted.

While voters backed expansion in 2017, the Republican governor has blocked startup funding for the law. Maine’s high court ordered the state to file an expansion plan last month, but the federal review comes as legal questions on implementation still sit before a lower-court judge.

Diane Rowland, the executive vice president at the nonpartisan Kaiser Family Foundation, said on Wednesday that it puts Maine in “uncharted waters” on expansion, adding that it isn’t the Centers for Medicare and Medicaid Services’ role to reject plans conforming to the federal Affordable Care Act. But questions about how Maine will pay its share could lead to delays.

Most of the Medicaid expansion debate between states and the federal government has focused on waivers, but Maine is officially asking to follow the law. Federal law allows CMS to let states waive portions of Medicaid provisions, which allows for state-by-state experimentation with certain policy ideas. When it comes to coverage, this cuts both ways.