Maine sued over missed Medicaid expansion deadline

Maine patient advocates sued the state health department and commissioner Monday over the missed April 3 deadline to file the plan to expand Medicaid, as required by a voter-passed ballot measure from 2017.

The legal aid not-for-profit Maine Equal Justice Partners sued on behalf of consumer advocacy groups and the state association for community health centers. They want to force Maine's health department to file the state plan amendment required by the CMS. The group claimed the amendment must be filed soon, as the state has until July 2 to launch enrollment for the expanded population.

Approximately 70,000 people would become eligible for Medicaid under the expansion. But GOP Gov. Paul LePage insists the Legislature must first figure out how to fund it.

"This is about holding the executive branch accountable," said Trish Riley, CEO of the National Academy for State Health Policy.

The patient advocates have also asked the court for an expedited decision within seven days. Riley told Modern Healthcare that if the health department misses the July 2 enrollment-launch deadline, the state could face another lawsuit.

At a Monday news conference, the groups said the decision falls to state Attorney General Janet Mills.

"If the AG agrees with us, it will be over very quickly," representing attorney Jamie Kilbreth said, adding that the "best-case scenario" was that the case could be over in a day or two if Mills orders the commissioner to file the state plan amendment with the federal government.

Mills, who's running for governor this year as LePage's administration comes to an end, has skewered LePage for opposing Medicaid expansion and praised the voter-backed law.

"As attorney general, I'm fully committed to ensuring Medicaid expansion is implemented now, in accordance with the will of the people," Mills wrote on her campaign website.

A LePage spokesperson declined to comment citing the now-pending litigation, but said the governor's position on the issue has not changed since his December 2017 letter to the Legislature.

In the letter, LePage demanded that lawmakers find the money to pay for expansion without increasing state taxes, diverting money from the Budget Stabilization Fund or using any other "one-time funding mechanisms or budget gimmicks." LePage asked for $60 million in budget savings in his State of the State speech this year.

A conflicting report from Manatt Health projected the state will only need $30.5 million to cover what the federal government won't.

The state's own Legislative Office of Fiscal and Policy Analysis put Maine's cost for fiscal 2017 at $39 million.

The state Legislature adjourned April 18 without making an appropriation, but the advocacy groups contend that should not block the executive branch from implementing the law since the Medicaid program has enough money in its budget to fund the expansion through May or June of 2019. They argue that the funding should last no matter which cost estimate is used as the baseline.

Robyn Merrill, executive director of Maine Equal Justice Partners, called LePage's punting to the Legislature an "empty excuse."

"The law is the law, and he needs to follow it," Merrill said.