What’s next in the bureaucratic fight over Medicaid expansion

Good morning from Augusta, where the new place to watch the fight on Medicaid expansion will be within the state’s bureaucracy. Monday was the day that Mainers are eligible for coverage in those expanded categories under the law approved by voters last year.

Advocates are assuring eligible people that they can get coverage back to July 2  — eventually, given the existing legal fight over expansion. The administration of Gov. Paul LePage, an expansion opponent, isn’t saying much. But the governor intimated last month that the state could reject applications out of hand if it has too many to process.

A lawyer for advocates says they expect the state to handle applications normally at first. The July 2 deadline is the deadline by which more than 70,000 Mainers are supposed to be eligible for expanded coverage. Maine Equal Justice Partners, a progressive group that advocated for expansion, is urging eligible people to apply and has created an online screening tool.

What’s unclear is how the department will treat applications. LePage said in a radio address last month that it would be “impossible” for staff to handle a rush of applications within the 45-day window allowed by law. If the state doesn’t process an application within that period, the person become eligible for coverage.

In response to that, the Republican governor said this would “force DHHS to simply deny all applications they don’t have time to review.” That which would likely draw a lawsuit from advocates if valid applications were caught up in it.

But Charlie Dingman, a Maine Equal Justice Partners attorney, said, “We don’t expect that to actually happen.”

The department has developed an application form that asks whether people are applying for expanded coverage. Dingman said he doesn’t expect immediate rejections. A DHHS spokeswoman didn’t answer a question on Monday about whether there was an inordinate amount of applications, referring a reporter to LePage’s radio address.

There are already pending fights in court and in the Legislature on other issues. Medicaid expansion is already in Maine’s court system, awaiting July 18 arguments before the Maine Supreme Judicial Court. The main issue between the state and Maine Equal Justice Partners in that case is whether the Department of Health and Human Services has to submit a plan to the federal government that was due in April.

That was the first major deadline under the law and the LePage administration missed the deadline, saying that it didn’t have to comply because the Legislature hasn’t dedicated funding to expansion yet. In related news, LePage vetoed a start-up funding bill on Monday.

The Legislature will return to Augusta in July 9 and could take up the override of that veto then or soon after. So, the legal and legislative fights on this could give us more information on how applications are going to be handled.

Maine Equal Justice Partners has promised to sue again if coverage is denied after the deadline, but Dingman said his group is trying to meet with the department to see how it will process applications or get information from applicants before making that determination.

“Until we either have that conversation or we see what’s happening as people submit their applications, we won’t know precisely what’s going on,” he said.

LePage inks 23 new vetoes

The major vetoed bills were non-surprises. The governor handed down 23 new vetoes on Monday, including three that he already announced and others that were widely expected. That first category includes the Medicaid expansion funding bill and two supplemental budget bills that would increase reimbursement rates for health services and fund county jails. Other notable bills are endangered by LePage’s veto pen.

They include one that would fund the Downeast Correctional Facility, a closed Machiasport prison, and a so-called “red flag” bill that would allow a judge to order certain people deemed to be dangerous to surrender firearms while undergoing mental health treatment.

The prison was closed in a snap by the governor in February and re-opened minimally after a court order in March. It ran out of funding on June 30 and LePage said in a veto letter that re-opening it now would be illogical. He said the red flag bill’s evidentiary burdens were too low.

Reading list

  • U.S. Sen. Susan Collins says she won’t endorse a Supreme Court nominee who is who has ‘demonstrated hostility’ to Roe v. Wade. The pro-abortion rights Republican, who met with President Donald Trump last week on his eventual pick to replace retiring Justice Anthony Kennedy, told CNN on Sunday that would indicate a lack of “respect for established decisions.” But she has also said that she wouldn’t have a “litmus test” for a nominee’s personal views on abortion. Collins doesn’t look likely to break from Trump yet. She’ll face pressure from liberals throughout this process and Trump is expected to announce his nominee next week.
  • Maine likes to borrow money to fund roads and bridges, but it may be bad policy. There’s nothing more politically unifying than transportation bonds, which routinely pass at referendum are getting so common that the Maine Department of Transportation works $100 million in annual bonding into its work plan. The problem? Maine will have to pay $30 million in interest alone on $321.5 million on this borrowing since 2012. Advocates say Maine lawmakers need to find a way to solve a larger road funding problem, driven in part by ever-lower gas tax returns.
  • It’s hot and it’s going to be hot. Temperatures throughout Maine will be in the 90s and could reach up to 100 degrees through the holiday week. Be safe out there. Here’s your soundtrack.

Editor’s note

The Daily Brief will be off tomorrow for Independence Day. We will return on Thursday. Here’s our list of Fourth events around Maine and here’s your soundtrack. — Michael Shepherd

Today’s Daily Brief was written by Michael Shepherd. If you’re reading this on the BDN’s website or were forwarded it, click here to get Maine’s only newsletter on state politics via email on weekday mornings.

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Michael Shepherd

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.