EDITORIAL: LePage’s continued refusal to implement Medicaid expansion is unfair, but unsurprising

Nov. 26--November 26, 2018 1:23 pm

Gov. Paul LePage has an undeniable point that Medicaid expansion should be done in a fiscally responsible way that improves access to health care without threatening the sustainability of existing state programs.

As demonstrated in a Superior Court ruling last week, however, LePage and his administration are wrong in their continued refusal to implement the voter-approved expansion law expected to provide 70,000 low-income Maine people with health coverage.

LePage has repeatedly thrown up roadblocks to Medicaid expansion, which would extend Medicaid benefits to people with incomes between 101 percent and 138 percent of the federal poverty level and is available to states under the Affordable Care Act.

The low-income and working Mainers who would benefit from this expansion are stuck in health care limbo while the administration drags its feet implementing a law that 59 percent of voters approved last November.

Last week, Maine Superior Court Justice Michaela Murphy ordered LePage's administration to implement rules for the expansion law by early December as part of a suit brought by the advocacy group Maine Equal Justice Partners.

"Although the Governor may believe implementation to be unwise and disagree with the Act as a matter of policy, he may not ignore the will of the people and refuse to take any action toward accomplishing the policy objectives of the Act," Murphy said in a 21-page decision issued Nov. 21.

A LePage spokeswoman confirmed Monday that the governor plans to appeal Murphy's ruling. So as Maine nears the end of LePage's second term, we have at least one last look at his unwillingness to admit when he's wrong.

LePage has taken a legitimate policy concern about sustainability and fiscal responsibility, and rather than work constructively to address that concern, instead used it as an excuse not to implement a law that he has continually opposed.

The governor has vetoed expansion legislation five different times, leading advocates to take the issue straight to voters with the ultimately successful 2017 referendum.

LePage is correct that the referendum did not include a funding mechanism, but he scuttled the Legislature's attempt to appropriate more than $54 million for Medicaid expansion with a July veto that was ultimately upheld. The Legislature's plan was a less than perfect short-term fix, but LePage's own funding suggestion, an additional tax on Maine hospitals, was likely a non-starter from the beginning.

LePage's longstanding and continued opposition to Medicaid expansion suggests that his fiscal responsibility objection is, at least in part, an argument of convenience. By clinging to that argument, the governor is delaying health care coverage for some of our state's most vulnerable residents.

Medicaid expansion loomed large in Maine this election season. With vocal expansion proponent Gov.-elect Janet Mills and her fellow Democrats taking control of the Blaine House and both chambers of the Legislature, there should be little doubt that LePage again lost the Medicaid expansion argument with voters.

It's past time for LePage to initiate Medicaid expansion in a responsible way, rather than using a reasonable funding concern as an excuse for inaction.

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