Long-Term Sustainability in Medicaid Begins with Addressing Current Challenges

June 19, 2013

John Martins, Director of Employee and Public Communications,(207) 287-5012 or john.a.martins@maine.gov

AUGUSTA – As Legislators prepare to vote to uphold or override the Governor’s veto on Medicaid expansion, Department of Health and Human Services Commissioner Mary Mayhew reminded Mainers Tuesday that fixing the current MaineCare program is critical to the long-term sustainability of the program.

“We should not consider building on the current Medicaid program. Its financial foundation is crumbling and unstable,’’ the Commissioner said. “We must fix the existing program and work with the federal government to create more flexibility, care for priority populations and to strengthen the financial foundation of this costly and unsustainable program.”

Governor Paul R. LePage noted that over the last decade, Maine’s Medicaid program has grown rapidly and has moved away from its original intent to provide services for Maine’s most vulnerable. “Maine’s Medicaid enrollment has gone from nearly 200,000 people in 2002 to 336,000 today and the total spending in Maine’s welfare program has increased by one billion dollars since 2002,’’ he said. “Maine’s previous welfare expansion did not significantly decrease the uninsured in Maine, which numbered 136,000 in 2001 and stood at 133,000 in 2011.’

Over the last several years, Medicaid rates for healthcare providers have been repeatedly cut to address the ongoing financial shortfalls in Medicaid because of increasing enrollment and utilization, the Governor added. As a result of these reductions, some Maine physicians have closed their practices to Medicaid patients, significantly reducing access to primary care services for Medicaid beneficiaries.

Both Commissioner Mayhew and Governor Paul LePage had asked the federal government for more flexibility to ensure that Maine’s Medicaid program can meet the needs of more than 3,100 elderly and disabled individuals on waiting lists waiting for critical services. The LePage Administration put forth a proposal for additional funding in the upcoming biennial budget that will move 85 people off the waiting lists, but additional flexibility from the Centers for Medicare and Medicaid Services is needed to create better access to critical services for these disabled individuals.

The federal government has agreed that reforms to improve the system are important. In fact, CMS Director Cindy Mann wrote: “Your interest in improving care and lowering costs through better integration of services and greater reliance on home- and community-based long-term care services and supports is very much aligned with CMS priorities…”Please be assured that we will do whatever we can to support you efforts.”

The Administration is not in favor of adding able-bodied individuals to its Medicaid program while the elderly and disabled continue to wait.

“Adding non-disabled individuals to our welfare program when we are failing to provide core services to thousands of disabled and elderly Mainers is unacceptable,” said Governor LePage. “I believe that our children, elderly and disabled should receive adequate services, but the reality is, the current system is not providing quality care to our most vulnerable, said Governor LePage. “Unfortunately, if the legislature chooses welfare expansion, Maine will be locked into hundreds of millions of dollars in long-term costs to provide free coverage to able-bodied adults rather than the disabled and the elderly.”

Commissioner Mayhew said that a decision regarding expansion should not be rushed. “We must continue our conversations with the Federal government to expand flexibility and care for priority populations. The Legislature seems to have manufactured a false and unnecessary sense of urgency to make a decision on expansion immediately, rather than taking the time to make a sound and sensible policy decision.”