Maine Governor Paul LePage reconsiders his opposition to Medicaid expansion

WASHINGTON—Maine’s governor, Republican Paul LePage, has dialed back his staunch opposition to Medicaid expansion and entered discussions with the Obama administration over the possibility of accepting billions in federal funding to provide health insurance for the state’s poorest residents.

The apparent shift comes just weeks after eight other Republican governors, once vocal critics of Obama’s national healthcare overhaul law, surprised conservatives by announcing their intent to expand Medicaid to those with incomes up to 138 percent of the federal poverty line.

The Supreme Court has ruled that the Medicaid expansion in the law is optional for individual states, leading a number GOP governors to initially say they would opt out. But one by one, some of them, including Florida’s Rick Scott and New Jersey’s Chris Christie, decided to embrace the expansion because it would serve their states’ uninsured populations and save state taxpayers money.

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How far LePage is willing to follow those governors remains to be seen. His spokeswoman said he was unavailable for an interview on Tuesday.

“We are in preliminary talks” with the U.S. Department of Health and Human Services, acknowledged Adrienne Bennett, LePage’s spokeswoman. “It’s very preliminary at this point. It’s premature for us to talk about anything.”

A Globe report last month highlighted how LePage, the sole governor in New England refusing to expand Medicaid, was going a step further and dropping current recipients from the rolls beginning in March.

By the end of the year, more than 44,000 Mainers, about 13 percent of the state’s Medicaid population, were scheduled to be dropped from the government-subsidized health insurance program.

Bennett said the March 1 cuts impacting 20,000 low-income parents, seniors and the disabled would remain in effect even if LePage were to expand Medicaid. But the expansion would benefit the roughly 24,000 adults under 138 percent of the federal poverty line whose coverage is scheduled to end in January 2014.

Bennett would not say when LePage is expected to decide.

“There are still a lot of unanswered questions regarding Medicaid expansion, and we are not at this point moving towards Medicaid expansion,” she said, without divulging the governor’s concerns.

The expansion issue resurfaced on Monday after Democrats in the Maine Legislature tied their plan to pay $484 million that the state owes to hospitals to expanding Medicaid. The Bangor Daily News and the Portland Press Herald first reported on LePage's willingness to reconsider.

LePage said in a statement Monday that he is focused on paying the hospitals.

“The Medicaid expansion is a totally separate issue,” LePage said. “The minute we pay the hospitals, we’ll talk about Medicaid expansion. But I won’t negotiate the details of Medicaid expansion in the press. How can we talk about expansion when we haven’t paid our bills yet? That’s how we racked up these unpaid Medicaid bills to hospitals in the first place.”

Maine is one of the few states to cover childless adults with incomes below the poverty line, but it can no longer afford to do so, said Mary Mayhew, LePage’s commissioner for health and human services.

Medicaid is a public health insurance program run by the states, which splits the costs with the federal government.

LePage, elected in 2010 as a Tea Party-backed candidate, has likened Medicaid to welfare and criticized able-bodied adults who receive taxpayer funded health care. Critics have accused LePage, the oldest son of 18 children who ran away from home at age 11 and lived on the streets, of callousness.

Advocates of Medicaid expansion pointed out that if LePage rejects Medicaid expansion, he would be leaving more than $3 billion in federal funding on the table over a decade. But they are cautiously optimistic that LePage will change his mind.

“We’re pleased to hear that the governor is considering exploring the opportunity to accept federal funds for Maine and providing low-income hardworking families with the security of having access to health care,” said Sara Gagné-Holmes, executive director of Maine Equal Justice Partners, a nonprofit that provides legal aide and advocacy for the poor.

Samarali Daniels, a 23-year-old mother of two in Augusta, said she and her husband, Ramon Badillo Perez, signed a petition recently for LePage to expand Medicaid. If he chooses not to, the couple’s coverage would end in January.

“I don’t want to get my hopes up too much because he’s one of the most extremist Tea Party Republicans,” Daniels said. “I’m hoping I’m wrong, but realistically I don’t really see it happening.”