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home : • politics : • government
January 27, 2020

11/19/2014 4:10:00 PM
Eye on Augusta: Court Blocks Gov.'s Attempt to Cut Health Care for Young Adults, LePage Vows to Take It to Supreme Court
by Andy O’Brien

On Monday, the First Circuit Court of Appeals smacked down an attempt by the LePage administration to eliminate health care coverage for 6,000 low-income 19- and 20-year-olds. The following day, Gov. LePage vowed to take the fight to the Supreme Court.

In a decision delivered by Chief Judge Sandra Lynch, the court ruled that the governor's proposal violated the federal Affordable Care Act's "maintenance of effort" provision, which requires that states accepting Medicaid funds continue providing their Medicaid eligibility standards until October 2019. Kicking young adults off of MaineCare, the state's Medicaid program, was part of the governor's 2012 effort to close a $220 million budget hole by eliminating health coverage for 20,000 Mainers, including seniors, parents, the disabled, and childless adults.

Dubbed the "Nation's Toughest Medicaid Cuts" by the Pew Charitable Trusts, in 2013 the federal Centers for Medicare and Medicaid Services (CMS) approved a number of the LePage administration's requests - including cutting MaineCare for parents earning over 133 percent of the federal poverty level (a monthly income of over $2,165 for a family of three). However, it denied his request to cut off young adults. In Maine, with its median household income of $48,000 per year, 31 percent of residents are enrolled in Medicaid, compared to the national average of 21 percent, according to the Kaiser Family Foundation. Maine's total Medicaid expenditures in 2012 were $2.4 billion, of which coverage for 19- and 20-year-olds represented less than two percent. Maine DHHS estimated that its proposal would save the state $3.7 million. But it would also cause the loss of $6.9 million in federal matching funds.

In its court brief, Maine's Department of Health and Human Services argued that the federal government's denial of the state's request to cut Medicaid for young adults was unconstitutional. The LePage administration cited a Supreme Court decision that struck down a provision of the ACA that mandated that states expand Medicaid. This, DHHS argued, meant that the federal government could not force Maine to maintain coverage for young adults. The opt-out provision created by the Supreme Court ruling has allowed the governor to veto five attempts to accept millions of dollars in federal Medicaid money to expand health care to 70,000 Mainers.

However, the court rejected the LePage administration's argument, pointing out that Maine is bound by its decision in 2009 to accept federal stimulus funds, which stipulated that states taking advantage of the program continue providing Medicaid coverage to low-income young adults. After the passage of the ACA in 2010, "ObamaCare" extended that period for another nine years as a condition of receiving Medicaid funds.

Prior to LePage's announcement of his intent to take the case to the Supreme Court, DHHS Commissioner Mary Mayhew said she would remain committed to reducing eligibility for MaineCare and said she would be reviewing her options of what to do next.

"Today, judges have gone out of their way to defend the unpopular ObamaCare law and obstruct the will of the public, made clear two weeks ago, that our welfare funds should be prioritized toward the elderly, disabled, and truly needy; not job-ready young adults," said Mayhew. 

But First District Democratic Congresswoman Chellie Pingree hailed the court's decision.

"Maine has covered these young adults for over 20 years, and dropping the coverage now clearly violates the provisions of the Affordable Care Act," Pingree said. "This is good news for thousands of low-income 19- and 20-year-olds who faced the loss of health care coverage."

Pingree had written to federal Health and Human Services Secretary Kathleen Sebelius in 2012 urging her to reject the LePage administration's request for a waiver to cut Medicaid. Maine Democratic Attorney General Janet Mills refused to defend the LePage administration's waiver request, and in a rare move, filed a separate brief defending the Centers for Medicare and Medicaid Services decision that LePage's proposal is unconstitutional. Without the support of the state's A.G., the governor had to tap $100,000 from his contingency account to hire private legal counsel. At press time, a governor's spokesperson did not return comments as to where he'll find the money for a Supreme Court fight.

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