Feds approve LePage’s push for stricter Medicaid rules, but Mills could end it

Dec. 22--By Michael Shepherd, BDN Staff --December 21, 2018 6:15 pm

Updated: December 21, 2018 6:19 pm

AUGUSTA, Maine -- Gov. Paul LePage won approval from the administration of President Donald Trump on Friday to apply work requirements and monthly premiums to the state's Medicaid program. But they may not happen with Democrat Janet Mills taking office in January.

Maine is the sixth state to win approval for work requirements in Medicaid since the Republican president took office in 2017. His administration has allowed states to restrict the program using Section 1115 waivers, which exempt certain Medicaid rules.

The changes would allow Maine to require Medicaid recipients to work 80 hours per month or meet other community engagement requirements and pay up to $40 in monthly premiums. Premiums would not apply to individuals with incomes equal to or less than 50 percent of the federal poverty level of just over $12,000.

In a statement, LePage said the changes would allow Maine to "continue expanding our available workforce" and "focus our resources on those individuals who need it most," but he won't have the final word because changes can't be implemented until July 2019 and the state can suspend the agreement under the waiver terms.

The American Lung Association urged Mills to stop it once she is sworn in Jan. 3, saying in a Friday statement that the changes "do not further the goals of the Medicaid program or help low-income Mainers get health insurance."

Mills, the outgoing attorney general, has been noncommittal on the waiver, but she seemed to take a dim view of it Friday. Scott Ogden, her spokesman, said she has not reviewed it yet, but she prefers training and education programs to "bureaucratic mandates" in order to fill jobs.

The Democrat has vowed to expand Medicaid under the federal Affordable Care Act, which was approved by voters in 2017 but has been held up by a court fight between advocates and the LePage administration. Earlier this month, a judge ordered the state to implement expansion by February.

Arkansas, which implemented similar Medicaid work requirements for those covered under expansion, saw nearly 17,000 people of the roughly 250,000 people in the program lose health coverage between September and November, according to the Kaiser Family Foundation.

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