Augusta, MAINE – Today, Governor Janet Mills sent a letter to the Centers for Medicare & Medicaid Services informing the agency that Maine would not accept the terms of the pending 1115 Medicaid waiver. Instead, Governor Mills has directed Acting Commissioner of Labor Laura Fortman and Acting Commissioner of Health and Human Services Jeanne Lambrew to make available vocational training and workforce supports to MaineCare participants at every opportunity while increasing access to needed services that keep people in the workforce.
“Maine’s low unemployment rate, its widely dispersed population, and our lowest per capita income in New England make mandates – without appropriate supports like vocational training and specific exemptions for groups like people undergoing treatment – problematic,” wrote Governor Mills. “We believe that the likely result of this 1115 demonstration would leave more Maine people uninsured without improving their participation in the workforce.”
Governor Mills stated that her Administration prefers to make training available to those enrolled in MaineCare, and, to that end, she has directed Acting Commissioners Lambrew and Fortman to increase coordination between their departments to promote work-related opportunities.
“Ensuring that Maine people have access to health care and are healthy is the first step to getting them back into the workforce,” said Acting Commissioner Lambrew. “Waiving protections against high premiums and for retroactive coverage would only reduce access to that critical coverage, including preventive services, mental health care, and treatment for substance use disorders. The Maine Department of Health and Human Services will continue to see that Maine people have health care coverage that enables them to find work, and I look forward to working closely with Acting Commissioner Fortman to connect people on MaineCare with greater educational and training opportunities.”
“The Department of Labor looks forward to working with the Department of Health and Human Services to ensure that educational and training opportunities are readily available to those on MaineCare,” said Acting Commissioner Fortman. “Maine is in the midst of a serious workforce shortage, which is why it is crucial that we continue to make sure that every Maine person has the support and resources they need to find and keep work.”
Many MaineCare recipients already participate in our various work program opportunities and, through collaboration, DHHS and the Department of Labor will offer health and work opportunities to a greater number of people in the coming months. Consistent with the Governor’s direction, the Department of Health and Human Services will support Maine residents develop their skills and find good jobs by:
Maximizing the use of Temporary Assistance for Needy Families (TANF) funding. The services provided through TANF include job readiness and job search trainings that prepare participants to enter the workforce; targeted skills development, training and education; connecting participants with employers, and job retention services once the participant has earned a job. In the last two years, the program has helped over 5,700 individuals across the state get jobs.
Rapidly implementing the Higher Opportunity for Pathways to Employment (HOPE) program, enacted during the most recent legislative session. As early as the next school year, this program will provide a robust set of supports for low-income families seeking higher education and skills training.
Connecting participants in Maine’s Food Supplement Program to jobs. For example, all Food Supplement recipients who meet the federal Supplemental Nutrition Assistance Program (SNAP) qualifications to be a “work registrant” (about 20,000 individuals) set up a “job link” account with the Maine Department of Labor, which is designed to connect job seekers with employers. Additionally, Maine administers a Food Supplement Employment and Training Program (FSET) that has received national attention for its support of the two-generational post-secondary education program Family Futures Downeast. FSET also partners with Goodwill of Northern New England to develop job skills for SNAP recipients who voluntarily participate in the program.
Continuing the SNAP to Skills Project. This work is strengthening Maine’s SNAP Employment and Training (SNAP E&T) program to help more participants find work and reduce their need for SNAP. Maine has committed to growing its FSET program, with the goal bringing on new partners and serving SNAP recipients throughout the state.
The Department of Labor will continue to target SNAP and TANF recipients through the Competitive Skills Scholarship Program, the CareerCenter system and the Workforce Innovative and Opportunities Act to help them obtain work by:
- Helping workers learn new skills to succeed in the changing economy through the Department of Labor’s Competitive Skills Scholarship Program. It pays for education/training and support services for high-wage jobs in-demand in Maine. Eligibility criteria include a family income of no more than 200 percent of federal poverty or family receipt of TANF or Food Supplement benefits and a desire to earn a marketable college degree or post-secondary occupational certificate considered to lead to high-wage and in-demand occupation.
- Connecting TANF and Food Supplement participants to the Workforce Innovation and Opportunity Act education, employment and training services to promote education, training, and job placement.
- Connecting participants with the Maine CareerCenter system which provides a full range of assistance to job seekers under one roof. The centers offer training referrals, career counseling, job listings, and similar employment-related services.
Mounting evidence demonstrates that work requirements only impose burdensome mandates on people without increasing workforce participation. In Arkansas – an early state to implement Medicaid work requirements – results show that thousands of people have lost health coverage but were not moved into the workforce. Additionally, these conditions for Medicaid coverage are of questionably legality. In June 2018, a federal court put a stop on Kentucky’s effort to move forward with these conditions.
A complete copy of Governor Mills’ letter is attached and below:
January 22, 2019
The Honorable Seema Verma. Administrator, Centers for Medicare & Medicaid Services
U.S. Department of Health and Human Services
Hubert H. Humphrey Building, Room 445–G
200 Independence Avenue, SW
Washington, DC 20201
Dear Administrator Verma:
Thank you for your December 21, 2018 letter informing the Office of MaineCare Services of your approval of the state’s request for a section 1115 demonstration for MaineCare. I am writing to inform you that, after a careful review of the waivers in the 1115 demonstration and assessment of its potential impacts, I have directed my Acting Commissioner of Health and Human Services to not accept the terms you set forth.
While we appreciate the Centers for Medicare & Medicaid Services’ consideration, Maine’s low unemployment rate, its widely dispersed population, and our lowest per capita income in New England make mandates – without appropriate supports like vocational training and specific exemptions for groups like people undergoing treatment – problematic. We believe that the likely result of this 1115 demonstration would leave more Maine people uninsured without improving their participation in the workforce.
Maine prefers instead to make employment and volunteer opportunities and training available to its low-income adult population to fully encourage work while providing access to the health care that is so vital to keeping people in the workforce. Additionally, Maine prefers not to increase administrative burden for medical providers and for the state that would result from a constant screening of patients’ hours, categories, and types of community engagement. Instead, we should focus our resources on making the population healthy and work-ready to the fullest extent.
Maine believes that providing appropriate educational opportunities and vocational training, along with critical health care, is the most effective way to lift people out of poverty and into the workforce. To that end, I am directing the Acting Commissioners of the Maine Departments of Labor and Health and Human Services to make available vocational training and workforce supports to MaineCare participants at every opportunity, while increasing access to needed services that will keep them in the workforce. We will also coordinate with employers and the business community to enhance connections between them and participants who are able to work.
Again, thank you for your consideration. We look forward to working with you in the future on advancing access to health care services.
Janet T. Mills
Governor Mills letter regarding the pending 1115 Medicaid waiver (PDF)