LePage administration to ask Trump to OK list of Medicaid changes

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Good morning from Augusta, where the LePage administration revved up the news cycle this morning with a letter outlining changes to the state’s Medicaid program that they want green-lit by President Donald Trump.

The impact of all of these proposed changes is unclear, but they include premiums and other changes that the Maine Department of Health and Human Services said in a news release will be sent to the Trump administration as part of a waiver request “in the coming days.”

It’s part of a longstanding effort by the LePage administration to scale back MaineCare, Maine’s version of Medicaid, the federal health care program for low-income people. It touted culling 67,000 from the program between 2011 and 2015 and has proposed a change this year that would cut another 18,000 from the program.

Trump’s victory in 2016 led to speculation that Maine would be able to enact other welfare policies that President Barack Obama’s administration stymied, including a ban on buying junk food with food stamp money.

But the list of policies outlined in the letter from DHHS Commissioner Mary Mayhew to Rep. Tom Price, R-Georgia, who is Trump’s nominee for health and human services secretary, goes further than that to include:

  • Premiums and coinsurance: Mayhew said the state will request authority to charge $20 in a monthly coinsurance payment for all members, plus “reasonable monthly premiums” for adults in the program. Those payments would be limited to “populations who have the ability to earn income” and tailored to their ability to pay, but people who don’t pay required premiums would face temporary removal from the program. It’s intended to “engage individuals in taking responsibility for their own health.” Many states have some sort of premium in their Medicaid programs, according to the Kaiser Family Foundation.
  • An asset test: LePage has sought a $5,000 asset limit with certain exceptions for the food stamp program and Mayhew said they want one in Medicaid, too, but details aren’t fleshed out in the letter.
  • Not covering prior care: Mayhew says the state also wants to waive coverage of services incurred during the 90 days before Medicaid eligibility.

There are other changes, too. Keep it tuned to the Bangor Daily News for more context and responses today. — Michael Shepherd

Quick hits

  • The Maine Legislature is expected to pass a moratorium on parts of the state’s marijuana legalization law on Thursday. Advocates of the law passed by voters in 2016 have opposed the three-month moratorium, which will delay many provisions, including a retail sales system, until February 2018. But top lawmakers say they need more time to address issues with the law and it’s expected to pass, with Mary-Erin Casale, a spokeswoman for House Speaker Sara Gideon, D-Freeport, saying they intend to get the bill to LePage’s desk today. He has endorsed the idea of a moratorium.
  • U.S. Rep. Bruce Poliquin pressed Senate Majority Leader Mitch McConnell on ending the filibuster on Wednesday. POLITICO has an interesting report from inside the Republican retreat in Philadelphia, where House Republicans expressed frustration about legislation that has languished in the Senate. The upper and lower chambers are both now controlled by Republicans, but the Senate’s filibuster rule effectively makes it so legislation needs 60 votes to pass — allowing Democrats to hold things up. When McConnell noted that on Wednesday, Poliquin, a Republican from Maine’s 2nd District, asked him why the caucus wouldn’t change the rules, which are rooted in Senate tradition. Later, Poliquin told a reporter that there’s “a very impatient Republican House and a very impatient electorate” and members of his caucus “want to get things done.”
  • The Maine Republican Party will pick a new chair on Sunday. Chairman Rick Bennett is leaving his post (possibly to run for governor) and Vice Chair Demi Kouzounas, a dentist from Saco, is running to replace him at the state committee meeting on Sunday in Augusta. But sources say she’s facing a challenge from Matt Leonard of Auburn, the former executive director of the Lewiston-Auburn Metropolitan Chamber of Commerce. He didn’t respond to a Thursday message seeking confirmation. The candidates for vice chair are Blake Winslow of Presque Isle, the outgoing Aroostook County Republican Committee chairman, and Ryan Lorrain of Waterville, an aide to Maine House Republicans. Winslow said he wants to help grow the party, focusing on outreach in areas where Republicans narrowly won or lost in 2014, while Lorrain said he wants to ensure that legislative candidates “get a fair amount of attention” from the party.
  • A Trump move to temporarily halt Environmental Protection Agency grants apparently hasn’t had any impact in Maine. The grant freeze was highly controversial when reported earlier this week by the Huffington Post, but it’s expected to end on Friday, according to the trade publication E&E News. On Wednesday, Maine Department of Environmental Protection spokesman David Madore said “we have not received any official word regarding the temporary freezing of grants.” — Michael Shepherd with Christopher Cousins

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About Michael Shepherd

Michael Shepherd joined the Bangor Daily News in 2015 after covering state, federal and local issues for the Kennebec Journal for three years. He's a Hallowell native who now lives in Gardiner. He graduated from the University of Maine in 2012 and is a graduate student at the University of Southern Maine's Muskie School of Public Service.