Archive for February 25th, 2014

(UPDATED) Weekly Address of Governor Paul LePage, er, DHHS Commish Mary Mayhew: “Most Vulnerable Will Keep Paying the Price for Medicaid Expansion”

Posted on February 25, 2014. Filed under: Uncategorized | Tags: , , , , , , , , , |

(4:30 PM UPDATE): MDOL Commissioner Jeanne Paquette apparently didn’t think that her communications director Julie Rabinowicz expressed the department’s views clearly enough and as such, submitted her own statement moments ago:

    Statement from Commissioner Paquette: Growing Medicaid Budget Forces Cuts That Prevent Mainers from Getting Trained for New Jobs
    For Immediate Release: February 25, 2014

    Contact: Julie Rabinowitz, 207-621-5009

      AUGUSTA— Commissioner of Labor Jeanne Paquette has issued the following statement describing the effects of the growth of DHHS’s budget on the Department of Labor’s ability to assist the long term unemployed and the underemployed.

        Growing Medicaid Budget Forces Cuts That Prevent Mainers from Getting Trained for New Jobs

      Governor Paul R. LePage has said that because Maine already expanded welfare a decade ago, “Medicaid is now cannibalizing funding from all other state agencies.” This is particularly true in the Department of Labor, where loss of General Fund revenue has prevented many of our citizens from getting a hand up—not a handout—with a good job.

      Many of DOL’s job training programs and other initiatives to help businesses hire skilled workers were once funded by General Fund revenue or a mix of state and federal funding. But state funds have been cut drastically, leaving DOL dependent on shrinking federal dollars—dollars that come with many restrictions.

      Investments in job training targeted to high-wage, in-demand jobs provide a significant return; in general, trainees earn higher wages with better benefits than they did upon entering the program. The department’s programs are needed the most during economic downturns, yet our funding has declined, while demand for our services has increased.

      The department has not been able to sustain a number of programs that help people transition from unemployment and welfare back into the workforce.

      Forced by state funding cuts, DOL in 2007 and 2008 had to close almost half of its 22 CareerCenters, including sites in Rumford, Dover-Foxcroft, Ellsworth, Houlton, Belfast, Saco and Waterville, as well as satellite locations in Newcastle, South Paris and Madawaska. Little did the state realize how critical this decision would be just a few years later as these communities dealt with the recession.

      These closures severely limited Maine’s ability to assist the unemployed, making job-search support and job-training services much harder to access.

      Funding for another program, the Maine Enterprise Option, is gone. This program helped unemployment recipients start their own businesses by providing business management training. Running this program requires our staff to track and evaluate participants to ensure compliance with program requirements.

      Between 2006 and 2012, 2,730 people were trained to start businesses, including web and graphic design, bookkeeping, restaurants, dog grooming and bed and breakfasts. But federal Workforce Investment Act funding for this program went away, and we have no state resources to fund it. So DOL stopped enrolling people in 2012.

      The Department of Labor no longer upskills workers through the Governor’s Training Initiative, which was funded at a little more than $3 million in 2004, fell to $501,984 in 2010, then dropped to zero dollars in 2011.

      Just this year, the Legislature swept $2.5 million from the Competitive Skills Scholarship Program fund to balance the budget. This fund, paid by employers through an offset to unemployment taxes, helps low-income individuals train for high-wage, in-demand jobs. That $2.5 million would have trained an additional 360 people in 2014.

      Funding for the Maine Apprenticeship Program fell from a high of $622,907 in 2004 to $436,040 in 2013. In fact, current funding will not meet the needs of the existing sponsors/apprentices in our state.

      Focusing apprenticeship expansion efforts in Maine’s high-growth, high-wage industry sectors—healthcare, energy and precision manufacturing, for example—could increase training opportunities for unemployed or underemployed adults and teens. Apprentices earn while they learn; therefore, these people could be earning wages instead of collecting benefits.

      There are other programs that DOL cannot implement due to a lack of state funding. These are programs that would help develop Maine’s economy by creating a pipeline of skilled workers—something businesses look for when deciding to locate in a state or region.

      The department could offer a subsidized wage program to wean people off unemployment while allowing them to receive on-the-job training in a new career or with a new employer.

      The department could conduct an annual job vacancy survey of employers. This would provide real-time data to ensure that our scarce training resources are invested in skills and occupations that employers are actually looking for and hiring.

      The state could implement the industry partnership program for workforce development—a program included in last year’s budget by the legislature but not funded. Industry partnerships have been effective in other states to leverage private-sector support to develop industry-specific training. Maine’s recent healthcare sector grant showed that we have the ability to do this and our people and our businesses can reap huge rewards from implementing this collaborative training model.

      It’s the same refrain. No money for training. But training is an investment with a return—better jobs with benefits, higher wages and a career ladder for future promotions, economic growth and a brighter future for our children.

      Sadly, Maine has to forego this investment to feed the beast that is DHHS. DOL has utilized best practices and streamlined where ever possible—doing more with less.

      But if Medicaid expansion continues to absorb a greater portion of the state’s General Fund dollars, departments like Labor will ultimately be doing “less with less”—the opposite of the best interests of unemployed and underemployed Maine citizens.

    Commissioner Jeanne S. Paquette brings more than 20 years’ experience in human resources and workforce development to the Department of Labor. She is a member of the Society for Human Resource Management Maine State Council’s HR Hall of Fame.

———-

Last night progressive site Dirigo Blue broke the news that that either Governor LePage’s office or DHHS enlisted the communications directors from other Maine state agencies to lobby against Medicaid expansion:

lepage sots angry self

  • John Bott – Department of Agriculture, Conservation and Forestry
  • Doug Dunbar – Office of Fiscal and Program Review
  • Scott Fish – Department of Corrections
  • David Heidrich – Department of Administrative and Financial Services (DAFS)
  • Jennifer Smith – Department of Administrative and Financial Services
  • Jessamine Logan – Department of Environmental Protection (DEP)
  • Stephen McCausland – Department of Public Safety
  • Jeff Nichols – Department of Marine Resources (DMR)
  • Julie Rabinowitz – Department of Labor
  • Ted Talbot – Department of Transportation (DOT)
  • Doug Ray – Department of Economic and Community Development
  • Samantha Warren – Department of Education (DOE)

Now this afternoon comes the weekly address from Governor LePage’s office, shared with no embargo. In the past, First Lady Ann LePage has stepped in for her husband on rare occasions, but this address by DHHS Commissioner Mary Mayhew is an unprecedented move by the administration and signals there will most likely be push back on earlier reports of GOP lawmakers working with their majority Democratic counterparts to expand Medicaid.

Below Mayhew’s radio address are the letters from those communications directors, as shared by LePage’s office last night.

Audio link here. Most Vulnerable Will Keep Paying the Price for Medicaid Expansion

      Most Vulnerable Will Keep Paying the Price for Medicaid Expansion


    Difficult decisions must be made in Augusta. Tough choices are needed to ensure that state government can live within its means and that we can support and care for those who need us most.

    An irate DHHS Commissioner Mary Mayhew answers questions asked by Rep. Peter Stuckey (D-Portland) on January 14. Beside Mayhew is Gary Alexander, who had previously spoken to the HHS committee about his infamous report denouncing Medicaid expansion.

    An irate DHHS Commissioner Mary Mayhew answers questions asked by Rep. Peter Stuckey (D-Portland) on January 14. Beside Mayhew is Gary Alexander, who had previously spoken to the HHS committee about his infamous report denouncing Medicaid expansion.

    Hello, this is Maine Department of Health and Human Services Commissioner Mary Mayhew.

    Currently the Legislature is debating whether to add another 100,000 people to MaineCare, the state’s tax-payer funded healthcare program, at a cost of more than $800 million over the next ten years.

    At the same time, there are thousands of elderly and disabled on waitlists for services to help support them in their homes and in their communities.

    Most of us know someone in this situation. It’s an 80 year old mother who is struggling to care for her 50 year old son with Down syndrome. She needs help today and is worried who will care for her son when she is no longer around.

    It’s the parents of an autistic child who should be celebrating the accomplishment of their child graduating high school. But instead, they are panicked because their child is being placed on an adult waitlist for critical support services. Their child cannot be home alone.

    Maine is one of the oldest states in the country and the demands for services will only be increasing in the years to come. Everyone is worried about how best to care for an elderly parent, grandmother, aunt, or uncle.

    These are real people – the elderly and developmentally disabled – and far too many of them are waiting for services. The state needs more than $45 million to cover the services for these individuals.

    There are tough decisions that must be made in Augusta. We just finished paying off a $750 million debt owed to Maine hospitals because of the unbudgeted costs of the last expansion. We cannot repeat history and expect a different outcome.

    Democrats say that adding 100,000 people to Medicaid is somehow free, but we all know better. Medicaid has grown by more than $1 billion over the last ten years because of previous expansions and the reality of healthcare cost increases. It is nonsensical to believe that after years of financial crisis in Medicaid that the answer today is to add another 100,000 people to the program. Don’t be fooled by efforts to combine expansion with a fancy legislative proposal to manage care in Medicaid. The miraculous savings being advertised are not real and are only thinly veiled efforts to get support for a massive expansion of Medicaid.

    Mayhew fields all questions from Maine media regarding the $900k+ Alexander Report, while Gary Alexander stands silently by. He did not say one word to Maine press, who were instructed by Mayhew that she would be the only one speaking to them about the report.

    Mayhew fields all questions from Maine media regarding the $900k+ Alexander Report, while Gary Alexander stands silently by. He did not say one word to Maine press, who were instructed by Mayhew that she would be the only one speaking to them about the report.

    We do not live in a world of unlimited resources.

    If the state expands Medicaid our elderly and disabled will wait longer for services. That is a price we cannot afford to pay.

    Efforts to contain spending in the Medicaid program should be focused on meeting the needs of our most vulnerable and addressing other critical needs in state government like pay for state employees whose salaries have been frozen for years, investments in career centers to help people find jobs, or really funding education or helping to preserve important industries in Maine like lobstering, natural resources, and farming.

    Government cannot be all things to all people and we must put our most vulnerable citizens’ needs first and ensure that state government is effectively prioritizing our limited resources in the best interests of the future of this state.

    Thank you.

Video of DHHS Commissioner Mary Mayhew after the HHS Committee hearing on the Alexander report:

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(UPDATED) Maine GOP- Yes, REPUBLICANS!- To Attempt Compromised/ Combined Medicaid Expansion Bill

Posted on February 25, 2014. Filed under: Uncategorized | Tags: , , , , , , , , , , , , |

(11:45 AM UPDATE) The plan has now been released and as anticipated, it involves combining proposals from Senator Roger Katz and Speaker of the House Mark Eves:

      A key Republican senator on Tuesday will release his proposal to expand the state’s Medicaid program to more than 60,000 low-income Mainers, a move that could reshape a fiercely partisan debate that has raged at the State House for over a year.

      The proposal, sponsored by Sen. Roger Katz, R-Augusta, the assistant minority leader, is the result of a six-month effort to build support to expand a publicly funded health insurance program that has traditionally provoked fierce ideological and philosophical opposition among Republicans for its results and costs.

      Lawmakers will take up Katz’s bill before they tackle a separate expansion proposal sponsored by House Speaker Mark Eves, D-North Berwick.

Katz’s proposal includes a three year “sunset provision”, which he floated out to lawmakers as an amendment during last year’s LD 1066 floor debate. That motion passed the Senate by a 23-12 vote.

Democrats released more information on the proposal and statements from leadership:

    Democratic Leaders Issue Statement on Republican Health Care Expansion Proposal

    AUGUSTA — Top Democratic leaders in the Maine House and Senate issued the following statements in response to a proposal from Senate Republican Leader Senator Roger Katz of Kennebec to accept federal funds to provide healthcare coverage to 70,000 Mainers, including nearly 3,000 veterans.

    In addition to accepting the federal funds, Sen. Katz’s proposal would:

    • Put in place a plan to reduce the wait list for individuals with intellectual disabilities seeking MaineCare services like home care;
    • Call for managed care to reduce healthcare costs;
    • Fund two new Medicaid fraud investigators in the Attorney General’s office;
    • Conduct a feasibility study to review Arkansas’ and Iowa’s plans to use the federal dollars to purchase private insurance;
    • Include a sunset provision after three years when federal reimbursement reduces to 95 percent and an opt-out provision if the match rate goes below 100 percent during the first three years. 

    Speaker of the House Mark Eves of North Berwick and Senate Majority Leader Troy Jackson of Allagash sponsored two separate measures to accept federal funds, and issued the following statements.

    DEMOCRATIC STATEMENT ON REPUBLICAN PROPOSAL

    Speaker of the House Mark Eves and Senate Majority Leader Troy Jackson wait before presenting their bills before HHS Committee.

    Speaker of the House Mark Eves and Senate Majority Leader Troy Jackson wait before presenting their bills before HHS Committee.

    “We view the proposal as a step forward after months of debate over how to ensure more families can have access to a family doctor,”  said Speaker of the House Mark Eves of North Berwick. “Our priority has always been securing life-saving health care for 70,000 Maine people. While we have been skeptical of managed care programs in the past, we look forward to hearing the details of the Republican proposal. We will want to make sure that the emphasis is on quality treatment; not simply denying care.”

    “The people of Maine are counting on us to do right by them. They’ve put their faith and their trust in us and asked us to represent them to the best of our abilities,” said Senate Majority Leader Troy Jackson of Allagash. “Health care is a right, and lawmakers who get health care from the state should think twice before denying it to their constituents.”

    Senator Katz is expected to present the Republican proposal to the Health and Human Services Committee on Wednesday at 3 p.m.

    ###

——————————————————

Rumor overnight via Maine Wire about state GOP lawmakers making a move to expand Medicaid seems to be accurate:

Senate Minority Leader Roger Katz (R-Kennebec)

Senate Minority Leader Roger Katz (R-Kennebec)

A pair of Republican state senators are set to roll out a bill that would expand the state’s Medicaid program, MaineCare — a proposal that so far has been largely opposed by Republican Gov. Paul LePage and rank-and-file members of the party. On Tuesday, state Sen.’s Tom Saviello, R-Wilton and Roger Katz, R-Augusta, will unveil their plan to members of their party during a caucus meeting and then take their pitch to the editorial boards of two of the state’s daily newspapers.

Democrats have also been uncharacteristically quiet about the measure, which would allow the state to accept federal funding to expand the state’s low-income health care system under the federal Patient Protection and Affordable Care Act.

But state Sen. Margaret Craven, the Senate chair of the Legislature’s Health and Human Services Committee, said she was setting aside time Wednesday for her committee to hold a public hearing on the measure.

The bill, LD 1487, “An Act To Implement Managed Care in the MaineCare Program” was carried over last July and as such, needs a simple majority to pass both chambers. However, it would need 2/3s vote as an emergency bill and to override a veto from Governor LePage, who is vehemently opposed to expansion.

Current thought is that LD 1578, “An Act To Increase Health Security by Expanding Federally Funded Health Care for Maine People”, would be tacked on as an amendment to the bill.

The Joint Standing Committee on Health and Human Services is scheduled for 3 pm work sessions tomorrow on LDs 1636 and 1663 after the conclusion of the legislative session (audio link here).
The news has garnered some positive and negative reactions among Republicans. Former LePage communications director Dan Demeritt posted on Twitter:

House GOP Communications Director David Sorensen fired off a press release before the senate caucus to media. Here is a portion:

      “Medicaid Mythbusters Round 1”

    Many of those eligible for Medicaid under an expansion would already be eligible for a federal health care subsidy, were they to buy their own health insurance on the private market.

    – The U.S. Congress, “can’t be trusted to sustain its Medicaid funding promises,” suggesting the state would be stuck footing the bill for any health care expansion.

    – An expansion of Medicaid would cause further defunding of existing state government programs including those that help pay for nursing home care.

Sorensen later took to Twitter himself, to share the following slap-down:

So what does all of this mean?

It would finally mean expansion of Medicaid to 70,000 Mainers, which Democrats have tried to do but been unsuccessful both as LD 1546, “An Act To Strengthen Maine’s Hospitals, Increase Access to Health Care and Provide for a New Spirits Contract” , the combination hospital debt payoff- Medicaid expansion- liquor contract bill and as the stand alone bill LD 1066, “An Act To Increase Access to Health Coverage and Qualify Maine for Federal Funding”.

This story is still unfolding and will be updated.

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