FOR IMMEDIATE RELEASE: Thursday, March 14, 2019
MEDIA CONTACT: Julie Rabinowitz, Director of Policy and Communication, 207-292-2722 ext. 102, Julie@mainepbp.com
Federal law may require state to pay all enrollee costs depending on plan approval date
AUGUSTA—The State of Maine could be on the hook for the full cost of individuals enrolled in Medicaid expansion under Governor Janet Mills’s Executive Order because of the lack of federal approval of the expansion.
As of Friday, March 8, Maine’s Department of Health and Human Services announced that it has enrolled more than 10,075 people under Medicaid expansion. Past estimates have pegged the average Medicaid beneficiary’s annual cost to the program at $7,000. This puts the average annual cost of the 10,000 people enrolled to date at $70 million dollars.
“Without federal approval of the State Plan Amendment (SPA) expanding Medicaid, the state of Maine is on the hook for all the costs of each enrollee. Although Maine’s SPA asks for approval as of a certain date, there’s no requirement the federal government must abide by it. Federal law is clear,” stated Julie Rabinowitz, director of policy and communication for Maine People Before Politics. “Until the SPA is approved, no one knows how much this will cost the state, and as of right now, those costs could exceed $70 million.”
The federal Centers for Medicare and Medicaid Services (CMS) have the sole discretion to determine when the new enrollees will be covered by the federal government, and there is no requirement that they cover enrollees’ expenses back to July 2, 2018. CMS could choose to cover these 10,000 enrollees at the start of the federal fiscal year or the date of Governor Mills’s Executive Order, forcing the state to make up the difference.
There is no requirement that the 10,000 enrollees work or volunteer as a condition of receiving Medicaid. The LePage Administration had received federal approval to require able-bodied adults to be employed, in training or school, of volunteering as a condition of Medicaid eligibility, but the Governor Mills announced in January that she would not implement the waiver allowing Maine implement the work requirements.
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