DHHS Supplemental Budget Proposal - 2012-2013
Maine must move its Medicaid program to align with national averages, away from a low-income health insurance program and back to a sustainable program that protects Maine’s most vulnerable.
We will reduce the above shortfall and begin the move to a sustainable program by:
- Moving toward the national average by restructuring eligibility and repealing coverage for certain groups including childless adults; 19- and 20-year-olds and parents.
General Fund Savings: $6.2 million in SFY12; $52.5 million in SFY13.
- Redesigning benefits to better align with the national spending average by eliminating certain optional services that are not federally required. These include chiropractic, dental, occupational and physical therapy, podiatry, adult family care, residential services provided through Private Non-Medical Institutions, and consumer-directed attendant services.
General Fund Savings: $3.1 million in SFY12; $76.7 million in SFY13.
- Instituting payment reform by establishing a two-brand name limit for prescriptions; setting time limits for suboxone coverage, reducing children’s behavioral health services, eliminating payment for smoking cessation products, reducing MR Rental subsidies to the HUD market value, reducing payments to Critical Access Hospitals, hospital outpatient and inpatient services; and limiting crisis services to serious and persistent mental illness.
General Fund Savings: $12.8 million in SFY12; $23.1 million in SFY13.
- Reducing contracts, capturing personnel savings and transferring tobacco settlement funds.
General Fund Savings: $25.1 million in SFY12; $55.2 million in SFY13.
Maine Medicaid – Important Facts
Enrollment Has Grown Out of Control
- Since 2002, Medicaid enrollment has grown by 78 percent. From 2000 to 2010, Maine’s population grew only 7 percent
- The number of Mainers receiving taxpayer-funded health care is 35 percent higher than the national average
Maine Exceeds the National Average in Medicaid Coverage
- Only 15 states cover 19 and 20 year olds
- Only 7 states cover childless adults with a similar benefit program
- 32 percent of Maine Medicaid spending is classified as ‘other services,’ while the U.S. average is just 13 percent.
Overall Medicaid Spending On the Rise
- Today, Medicaid represents 21 percent of all state funding, while in 1998, it represented 12.4 percent.
- In terms of all spending (state and federal), Medicaid accounts for 32 percent of the state budget.
- DHHS represents 45 percent of all spending (state and federal).
Medicaid Per Capita Spending Much Higher than the National Average
- In 2009, Maine’s per capita Medicaid cost was $1,895 per person vs. the national average of $1,187.
- 01/24/2012 - DHHS response to questions from the January 12th and 13th & 18th Work Sessions (Part I | Part II (PDF))
- 01/18/2012 - Answers to questions from January 11 Work Session (PDF)
- 01/18/2012 - DHHS responses deferred from the packet presented January 3 (PDF)
- 01/18/2012 - Updated DHHS Fact Sheets (PDF)
- 01/10/2012 - Shortfall presentation (PDF)
- 010/6/2012 - Answers to questions - Joint Session on PNMI (PDF)
- 01/03/2012 - HHS Packet (PDF)
- 01/03/2012 - PNMI Presentation (PDF)
- 12/14/2011 - Testimony (PDF) by Commissioner Mayhew before the Joint Standing Committee on Health and Human Services and the Joint Standing Committee on Appropriations and Financial Affairs On LR 2678
- 12/13/2011 - AFA Package (PDF)
- 12/13/2011 - Summary of MaineCare Shortfall Proposal (PDF)
- 12/10/2011 - MaineCare Financial Projection and Shortfall Analysis - Attachment A (PDF)
- 12/10/2011 - MaineCare Enrollment - Attachment B.pdf (PDF)
- 12/09/2011 - DHHS Analysis of Projected MaineCare Shortfall -- SFY 2012 (PDF)
- 7411 - Repeal Parents.docx (Word | PDF)
- Attachment (PDF)
- 7424 - Repeal Coverage for 19-20 (Word | PDF)
- Attachment (PDF)
- 7427 - Adult Family Care (Word | PDF)
- 7429 - Ambulatory Surgical Center Services (Word | PDF)
- 7430 - Consumer Directed Attendant Services (Word | PDF)
- 7431 - Targeted Case Management (Word | PDF)
- 7434 - Dental Services (Word | PDF)
- 7442 - Eliminate Occupational Therapy Services (Word | PDF)
- 7443 - Vision (Word | PDF)
- 7445 - Eliminate Physical Therapy (Word | PDF)
- 7446 - Podiatry (Word | PDF)
- 7448 - PNMI (Word | PDF)
- 7451 - Sexually Transmitted Diseases Clinics (Word | PDF)
- 7461 - Chiropractic Services (Word | PDF)
- 7462 - Non-Medicaid Elderly in a Residential Setting (Word | PDF)
- Attachement (PDF)
- 7464 - Critical Access Hospitals (Word | PDF)
- 7465 - Limit the Use of Brand Name Drugs (Word | PDF)
- 7467 - Hospital Outpatient Limit (Word | PDF)
- 7468 - Hospital Inpatient Limit (Word | PDF)
- 7469 - MR Rental Subsidy (Word | PDF)
- 7470 - Crisis Services (Word | PDF)
- 7471 - Suboxone Limit (Word | PDF)
- 7472 - Head Start General Fund (Word | PDF)
- 7474 - Repeal Childless Adults (Word | PDF)
- 7480 - Smoking Cessation Products (Word | PDF)
- 7481 - Reduce Hospital Reimbursement for Out-Patient by 5% (Word | PDF)
- 7482 - Wrap-Around ME (Word | PDF)
- 7483 - Family Reunification Program (Word | PDF)
- 7484 - Alternative Response Program (Word | PDF)
- 7486 - Children's Behavioral Services (Word | PDF)
- 7487 - MR Waiver Rate Reform (Word | PDF)
- 7488 - 10 Percent Reduction to Hospital Inpatient Rates (Word | PDF)
- Fund for Healthy Maine Proposed Cuts
- 7489 - Donated Dental Fact Sheet (Word | PDF)
- 7489 - Head Start (FHM) (Word | PDF)
- 7489 - Home Visitation Fact Sheet (Word | PDF)
- 7489 - Immunization Fact Sheet (Word | PDF)
- 7489 - Oral Health Fact Sheet (Word | PDF)
- 7489 - Purchased Social Services Fact Sheet (Word | PDF)
- 7489 - Family Planning (Word | PDF)
- Drugs for the Elderly/Medicare Savings Plan (Word | (PDF)