MaineCare Reform

Governor LePage?s DHHS Supplemental Budget Proposal

Maine Medicaid ? Important Facts

Enrollment Has Grown Out of Control

  • Since 2002, Medicaid enrollment has grown by 78%. From 2000 ? 2010, Maine?s population has only grown by 7%.
  • Maine provides government healthcare for 35% more of its population than the national average.
  • Maine has roughly twice as many people on Medicaid than students in public schools.

The Governor?s Plan Avoids Drastic Across the Board Cuts

  • Medicaid has expanded so much that other state agency budgets have been cannibalized for years.
  • Across the board cuts will result in the elimination of hundreds of state programs, affecting ALL Mainers.
  • The Governor is avoiding cuts to education funding, protecting Maine?s teachers and our children?s futures.
  • The Governor refuses to raise taxes on hardworking Maine families.

Maine Exceeds the National Average in Medicaid Coverage

  • Only 15 states cover individuals ages 19 and 20
  • Only 7 states cover childless adults with the same benefit package
  • Today, there are 361,000 Mainers on Medicaid. If Maine were at the national average, we would have 260,000 on Medicaid.
  • The Governor?s plan stabilizes the safety net for Maine?s most vulnerable, preserving benefits for over 285,000 Mainers.

Overall Medicaid Spending On the Rise

  • Maine?s population grew by only 7% from 2000-2010; however, Medicaid spending has grown by a whopping 78% since 2002.
  • Today, Medicaid represents 21% of all state spending, while in 1998, it represented 12.4%. It is consuming the state budget at a rapid pace.
  • In terms of all spending (state and federal), Medicaid accounts for 32% of all spending.
  • As a department, DHHS represents 45% of all spending (state and federal).
  • Medicaid spending has dramatically increased by $1 billion over the last decade, a 45% increase.
DHHS Budget

Maine must move its Medicaid program to align with national averages, away from a government health care program for many 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; parents and reducing eligibility for the Medicare Savings Plan.
  • 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 and vision services.
  • Reducing contracts with vendors, personnel savings and transferring tobacco settlement funds to Medicaid.

Full details on the plan to eliminate the budget shortfall can be found at www.maine.gov/dhhs/budget

OUT OF CONTROL ENROLLMENT GROWTH IN MEDICAID

MaineCare Enrollment

Frequently Asked Questions about Governor LePage?s Medicaid Reform Package

Are emergency rooms going to be overrun, and are the hospitals going to be broke because of the lack of Medicaid?

No. The assumption that people receiving Medicaid won?t make other arrangements and won?t pay their bills is inaccurate. The majority of states have a significantly lower number of Medicaid enrollees and lower insurance rates, yet we do not see a national crisis of closed hospitals.

Governor LePage has worked to re-pay and save Maine hospital services after years where the previous administration ran up I.O.U.?s with Maine?s hospitals.

Medicaid has been inappropriately used to address challenges with commercial insurance, creating a dependency on government spending ? sending Maine?s budget nearly over a cliff. Medicaid is for Maine?s most vulnerable.

Why are we moving away from PNMI Services? What is the plan to transition people from PNMI?

PNMI?s are Private Non-Medical Institutions. Maine is one of 2 states offering PNMI services using this option. PNMI is an optional service under Medicaid.

The federal government has expressed concern over the last several years that PNMI is not a model they endorse. They have a variety of concerns, including Maine using Medicaid dollars to pay for room and board. Room and board is not considered a medical service, and is not eligible for federal matching funds.

The Governor will work with the Legislature with the existing budget proposals to re-define services provided and to address priority services within the Medicaid program. PNMI is an optional service. Governor LePage has set aside nearly $40 million to address areas of need once the budget has passed and we look forward to working with the Legislature to resolve the PNMI issue.

Can?t we make these cuts elsewhere in state government?

The Governor does not support across the board cuts to all state agencies because it does not address the problem.
Across the board cuts will result in devastating reductions in education, public safety, economic development and other programs Maine people depend on. If broad-based cuts are implemented, all Mainers will be significantly impacted.

The facts are clear. Maine cannot afford its Medicaid program as it currently stands. Change must occur through restructuring eligibility, re-designing benefits and adopting payment reform which addresses structural problems and will put Maine?s Medicaid program on a path to financial responsibility.

Governor LePage is trying to save Maine?s Medicaid program from insolvency.

Is this truly a crisis, or is it politically motivated?
On April 1, 2012, the Department of Health and Human Services will run out of money to pay for Medicaid benefits. Currently, we are borrowing money from the fourth quarter to pay bills in the second quarter. There are no politics involved with these facts.

We will not be able to pay for services for those truly in need if the problem is not addressed now.

Maine can no longer:

  • Rely on federal stimulus money to pay for Medicaid bills ? there is none.
  • Refuse to pay its hospital bills ? a devastating tactic employed by the last administration that the Governor began to fix with his first budget. We will not destroy Maine?s hospitals.

Maine people deserve better and Governor Paul LePage is committed to overseeing a government that is held accountable and fiscally responsible.