In his second term, will LePage expand MaineCare? MD group predicts he will

BDN photo by Gabor Degre

BDN photo by Gabor Degre

One prominent Maine group suggested recently that Gov. LePage will make a U-turn on Medicaid expansion.

In his first term, Gov. LePage was a stalwart opponent of the Affordable Care Act, refusing to set up a state exchange and doing nothing to publicize the federal exchange, calling the IRS’s involvement in subsidies and the mandate akin to actions of the Gestapo, suing the federal government on several issues, and blocking MaineCare expansion.

All around the country, more and more GOP governors are moving toward Medicaid expansion. Often they’ve negotiated non-standard approaches with the Obama administration.

Texas might expand Medicaid, using the model Utah negotiated, which involves work requirements and co-pays.

North Carolina’s governor recently met with Obama and discussed expansion possibilities.

Wyoming put out a plan and Montana is working on a proposal.

Now, you may be thinking, enough about all those other states —  What about Maine?

The Maine Medical Association’s “Top Ten Predictions for Health Care in Maine and the Nation in 2015” includes one on Medicaid expansion. Number 4 of the ten predictions is:

The Maine legislature will enact a modest MaineCare expansion, proposed by Governor LePage.  The expansion will assist largely those individuals under 100% of the federal poverty level and will require a CMS waiver. [source]

Maine is leaving a huge amount of federal money on the table which, because Maine is a net receiver of federal funds, are monies that other states would be sending our way.

A lack of expansion stifles Maine’s economic growth.

Those funds are needed by Maine hospitals and, most importantly, would help many Maine people.

But might LePage really pursue an expansion, partial or not?

Given his strong opposition to it in the past and his party’s label of MaineCare as “medical welfare,” that would seem unlikely.

LePage has also been hostile to the federal government, most recently putting at risk food assistance for nearly a quarter million Maine people because he did not want to follow their rules for the use of federal money.

On the other hand, during the 2014 campaign, LePage did say he wanted to “find a way” to provide coverage to some of those eligible for expanded Medicaid.

Given those comments, as well as all the benefits of an expansion and the increasing tendency of GOP governors to choose expansion, perhaps some sort of expansion is possible.

I’ll be waiting to see what Gov. LePage says and does and, if he should endorse even a partial expansion, how his ideological and partisan allies react.

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Amy Fried

About Amy Fried

Amy Fried loves Maine's sense of community and the wonderful mix of culture and outdoor recreation. She loves politics in three ways: as an analytical political scientist, a devoted political junkie and a citizen who believes politics matters for people's lives. Fried is Professor of Political Science at the University of Maine. Her views do not reflect those of her employer or any group to which she belongs.