Maine Supreme Court orders Medicaid expansion to go forward

Maine's high court on Thursday ruled that Republican Gov. Paul LePage's administration must move forward to implement the state's voter-mandated Medicaid expansion even if it continues fighting the plan in court.

In a largely procedural 6-1 decision, the Supreme Judicial Court determined LePage's appeal of a lower court ruling requiring them to submit a Medicaid expansion plan to the CMS was premature, since most of the case's issues remain on the table.

Under the voter-passed initiative, Maine was supposed to start enrolling expansion beneficiaries by July 2. The initiative gave LePage until April 3 to submit a state plan amendment to the CMS. LePage balked at the measure and claimed he couldn't act on it until the state Legislature funded Medicaid expansion.

But that argument didn't hold up in court. Kennebec County Superior Judge Michaela Murphy in June ordered the state Department of Health and Human Services to submit a state plan amendment to the CMS by June 11 to implement the expansion. Now, Murphy will have to handle the rest of the case "in as timely a manner as possible," according to the high court ruling, and future decisions in the case could come up for high court review.

Three advocacy groups sued the LePage administration in April to force the state to cover an estimated additional 70,000 Mainers with incomes up to 138% of the federal poverty level on its Medicaid rolls.

"The law is the law, and today's ruling means that the LePage administration must comply and submit a plan for expansion," said Robyn Merrill, executive director of Maine Equal Justice Partners. "This is good news for the state, which can now draw down federal funds to pay for 90% of the cost of healthcare, and it's good news for the eligible Mainers who are waiting for their chance to go to the doctor or fill a prescription. This is a step forward."

In his dissent, Justice Donald Alexander criticized the lower court for "bypass(ing) those nettlesome questions" regarding whether the initiative comported with the state Constitution and ordering the expansion plan go forward.

LePage's communications director, Peter Steele, said the governor's team is considering its options moving forward.

"The decision does not address the merits of the constitutional issues raised by the governor, including the fact that an appropriation is required before any expenditure can be compelled by law," Steele said via email.

LePage previously had vetoed five bipartisan bills to extend Medicaid. This is his final year in office.