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Maine Gov. Paul LePage to hold up Obamacare Medicaid expansion after voters OK it

110817 Leonard LePage Maine Medicaid Expansion-pic
Gov. Paul LePage, a Republican, said that the expansion will need to be paid for first. (AP Photo/Robert F. Bukaty)

Maine Gov. Paul LePage said Wednesday he would not move to expand Medicaid in the state until lawmakers find a way to pay for it, a day after voters advanced a move to expand the program through a ballot measure.

“Credit agencies are predicting that this fiscally irresponsible Medicaid expansion will be ruinous to Maine’s budget," LePage, a Republican, said in a statement. "Therefore, my administration will not implement Medicaid expansion until it has been fully funded by the legislature at the levels DHHS has calculated, and I will not support increasing taxes on Maine families, raiding the rainy day fund or reducing services to our elderly or disabled.”

LePage previously vetoed Medicaid expansion in the state five times, saying Maine could not afford to pay for it. Under Obamacare, the federal government pays for the cost of Medicaid expansion early on but gradually dwindles support to 90 percent. States that expanded began to pay for 5 percent of the share this year, and some did so through taxes on providers.

The Maine Heritage Policy Center, a conservative think tank, estimated that over the next five years state spending on Medicaid would total nearly $400 million, reaching $100 million in 2022 alone and increasing steadily in subsequent years as medical inflation outstrips the rate of personal income growth.

A report by the legislature’s Office of Fiscal and Program Review pegged the state spending closer to $54 million a year and said the cost to the federal government would be about $525 million a year.

The Maine Heritage Policy Center in its report, however, raised questions about whether the federal government would follow through on its Medicaid contribution over time.

LePage in his statement pointed to an expansion of Medicaid in Maine tried in 2002 under then-Gov. Angus King, now an independent senator in Congress, as evidence to support his concerns about costs to the state.

“It created a $750 million debt to hospitals, resulted in massive budget shortfalls every year, did not reduce emergency room use, did not reduce the number of uninsured Mainers and took resources away from our most vulnerable residents — the elderly and the intellectually and physically disabled,” LePage said.

Maine is expected to become the 32nd state, not including the District of Columbia, to expand Medicaid under Obamacare to low-income people — those who make less than $16,643 a year.

Before Obamacare, states varied in who qualified for Medicaid, but generally the program paid for medical care for people with disabilities, pregnant women, and nursing home care.

Obamacare was originally written to mandate all states expand Medicaid to low-income people, but a Supreme Court decision made the provision optional for states. Maine is the first to expand the program through a ballot initiative rather than through a state legislature, and about 80,000 people in the state are expected to qualify for expansion coverage.

• This article has been corrected to include additional information about state and federal costs of the Medicaid expansion.