The Federal Government Approves Maine's Medicaid Expansion

After nearly 1 ½ years of political and legal hurdles the federal government has approved Maine’s Medicaid expansion, making federal matching funds available to Maine as one of 37 states plus the District of Columbia that have expanded Medicaid under the ACA.

Sixty percent of voters approved Medicaid expansion in the November 2017 election, making Maine the first state to expand the program through a citizen-initiated referendum.  Former Governor LePage consistently opposed expansion and refused to implement the law unless the legislature approved funding for it in the amount he claimed was necessary. His Commissioner of Health and Human Services, at the time, consequently refused to submit to the federal government a state Medicaid plan amendment necessary to trigger the 90% federal share of the costs of expansion.

When the Lepage administration failed to submit the application to implement the law pro-expansion groups filed suit.  Maine Equal Justice Partners, Consumers for Affordable Health Care, Maine Primary Care Association, Penobscot Community Health Care and five individuals sued DHHS and the LePage administration to force the administration to submit the plan and comply with the statute.  Drummond Woodsum attorneys Jamie Kilbreth and David Kallin were the lead lawyers for the Petitioners.

In November of 2018 Superior Court Justice Michaela Murphy found that the Maine Department of Health and Human Services had “failed and refused to comply” with the law passed by Maine voters in 2017 that would expand Medicaid under the federal Affordable Care Act.  In her ruling she said the LePage administration should have adopted rules and begun implementation no later than July 2nd, thus settling the issue of the effective date of coverage.

As a result of the lawsuit the State was forced to submit the first part of the expansion plan in September of 2018, and now the federal Centers for Medicaid and Medicare Services have approved Maine’s application retroactive to July 2, 2018, unlocking nearly $9 million in federal funds for last year, and almost half a billion in federal funds for 2019.  Governor Mills signed Medicaid expansion into law when she took office in January and since then more than 18,000 Mainers have signed up.  But even with the new Governor’s support, if this lawsuit hadn’t forced the issue when it did, then the federal government would have been unable to provide matching funds retroactive to July 2, 2018 and any submission by the new Governor in January would have been limited to 2019 forward.

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