Appropriations Committee Agrees Unanimously to Final Hospital Payment Plan, Refinancing Liquor Contract

Posted on June 11, 2013. Filed under: Uncategorized | Tags: , , , , , |

Appropriations and Financial Affairs Committee members hard at work in May.

Appropriations and Financial Affairs Committee members hard at work in May.

After Governor LePage on May 24 publicly vetoed LD 1546, which had provisions for expanding Medicaid, refinancing the liquor contract and paying the last payment on the hospital debt (that the Democrats have been paying down since 2006 under former Governor John Baldacci), it was back to square one for the three issues.

The first, LD 1066 “An Act To Increase Access to Health Coverage and Qualify Maine for Federal Funding” has now passed the Senate as amended and is working its way to the House, with expectations that it will be debated later this week- if not tomorrow.

That left the hospital debt and the liquor contract, in the form of Governor LePage’s bill LD 1555 “An Act To Strengthen Maine’s Hospitals and To Provide for a New Spirits Contract” as its own stand alone bill (it was referred to Appropriations and Financial Affairs committee on May 31).

tv hall of flagsSince then, the Governor has been impatiently tapping his toe, waiting and waiting and WAITING in frustration for his bill to come up for a vote in the Legislature.

To alleviate his boredom, LePage even went to Best Buy and got himself a new entertainment center on the taxpayers. The day after the bill was referred to AFA, the Governor in his weekly radio address demanded that Democrats “stop their deceitful gamesmanship”.

It needs to be noted that this statement by LePage was released to media on the same day as the committee was assigned the bill, with the Governor’s address embargoed until the following day, Saturday June 1- when the Legislature was not in session.

Who’s zooming who, Governor??

Earlier this afternoon, his office decided to nag a bit more with a late press release that read in part:

lepage head 2Governor Paul R. LePage today reminded Mainers that the hospitals still haven’t been paid.

    “It’s been 150 days and counting,” said Governor LePage. “How much longer must the hospitals wait? It is time to end the political games and get our hospitals paid. Democratic leadership has not allowed an up-or-down vote on my plan. Let’s get that vote, let’s get the hospitals paid, and let’s get our fiscal house in order so I can release job-creating bonds before the entire construction season ends this summer.”

    House Republican leaders Tuesday joined Governor LePage calling on Democratic leadership to bring forward the bipartisan measure to pay off Maine’s hospital bills without delay.

Within an hour of the Governor’s latest missive came word that the Appropriations Committee has unanimously passed an agreement on LD 1555. Here is part of their press release:

    Lawmakers on the State Legislature’s Appropriations and Financial Affairs Committee on Tuesday afternoon unanimously approved a measure to make a final payment on Maine’s hospital debt and refinance the state’s liquor contract.

    dawn hill“Today we are one step closer to another attempt at paying back the hospitals,” said Senator Dawn Hill, D-York, the Senate Chair of the Appropriations Committee. Recently, the governor vetoed our last effort. We all agree that we need to make the final payment to our hospitals, and it’s important we make the payment in a timely manner.”

    The bill is the second measure passed this session to make a final payment on Maine’s hospital debt. Governor Paul LePage vetoed the first, LD 1546, last month. This bill makes the final payment to Maine hospitals totaling $485 million in state and federal dollars. By paying the hospitals prior to October 1, 2013, the state will save $5 million. The payment would trigger a federal match of $298 million, completing final payment to Maine’s hospitals.

    peggy rotundo“This final payment closes a decade long chapter of repaying our debt to Maine’s hospitals,” said Rep. Peggy Rotundo, D-Lewiston, the House Chair of the Appropriations Committee. “Our hospitals are key to the health of our community and this final payment makes good on the lifesaving work that our nurses and doctors do for Maine families.”

One wonders how the Governor will react to getting his way… as well as the Republicans that supposedly continue to support him.

Will we see a continuation of “Chain of Fools” or will someone from his party finally get through about the value of “R-E-S-P-E-C-T”?

Stay tuned…

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Weekly Address of Governor LePage: Time for Dems to Stop Deceitful Gamesmanship, Pay Hospitals

Posted on June 1, 2013. Filed under: Uncategorized | Tags: , , |

(Note: The stresses within today’s share are mine and not as was sent out to media by the Governor’s office. dditionally, the title is mine- as sent, the address was entitled “It’s That Time Again!” ~AP)

Audio link here.

Folks, it’s deja vu all over again. Nearly five months after I submitted a plan to pay Maine’s hospitals, they still haven’t been paid. We’re back to square one.

lepage head 2Hello, this is Governor LePage.

Back in January, I submitted my plan to pay off the half-a-billion-dollar debt to Maine’s 39 hospitals. After 139 days, lots of delays and some last-minute political maneuvering, the hospitals are still not paid.

Democrats and Republicans agree my plan to use revenue from a new liquor contract to pay off the hospital debt is the best deal for Maine. With all of the public support for paying our bills, Senate President Justin Alfond and Speaker of the House Mark Eves know they can’t leave the State House without paying the hospitals. So what’s the hold up?

Democratic leadership pulled every trick in the book to avoid passing my plan. First, they held off hearing the bill for as long as they could. Then they claimed it was unconstitutional. Then they came up with a new deal for the liquor contract, which was pretty much the same as the old bad deal.

Then they replaced my bill with a committee bill that had all the elements of my plan, just to save face. Their final strategy was to tie the hospital payment to a huge expansion of welfare. They knew welfare expansion wouldn’t pass on its own merits, so they used Washington-style politics to force it through without bipartisan support.

Public support for my plan has been strong since day one. The Maine people want to pay the hospitals. In fact, they demand it.

This campaign by Democratic leadership to avoid paying the hospitals has serious consequences. Their political shenanigans have caused layoffs and prevented shovel-ready construction projects from getting started. Their refusal to pay the hospital debt is causing Maine’s credit rating to suffer.

Folks, I was not subtle. I said many times I would veto the bill if it was tied to expansion. And that’s exactly what I did. Seventy percent of Mainers believe the hospital bill should not be tied to welfare expansion.

Democratic leadership ignored the will of the Maine people, and they wasted valuable time on a bill they knew would get vetoed. They did this to appease their masters in Washington, D.C. and to please their special-interest groups at home. Democrats showed they care more about the Maine Peoples Alliance than the Maine people.

My plan will put many of those Mainers to work right away. It would pay 484-million-dollars to 39 hospitals, which provide some of the state’s best-paying jobs to Mainers. It would release about $100 million in voter-approved bonds and instantly create jobs in the construction industry. It would authorize a $100 million bond for transportation projects to fix our roads, bridges and other infrastructure.

My plan for a new liquor contract would return millions of dollars a year to Maine, rather than sending all that money to an out-of-state company. The new contract would benefit consumers, agency stores and the workers they employee. My plan was a good deal for Mainers five months ago, and it is a good deal today. Once again, I ask: What’s the hold up?

It’s time for Democrats to stop their deceitful gamesmanship. It’s time to pay the hospitals.

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ICYMI: Maine Speaker of the House Mark Eves Urges Passage of Medicaid Expansion Bill LD 1546 (Video; Text)

Posted on May 28, 2013. Filed under: Uncategorized | Tags: , , , , , , , , , , , , |

(On Wednesday (5/29/13), the House is expected to take up LD 1546 again in an evening session. Here again is the floor speech of Speaker of the House Mark Eves (D-N Berwick), urging his colleagues in the House join him in supporting this important bill. ~AP)

(Over 50 clips of individual House members rose to deliver testimony both in support and in opposition last night, as the bill LD1546, “An Act To Strengthen Maine’s Hospitals, Increase Access to Health Care and Provide for a New Spirits Contract” got its first reading and roll call votes in the House. More to follow. ~AP)

Below is the full text of Speaker Eves’ remarks as prepared and released to media. Note: House Majority Leader Seth Berry (D- Bowdoinham) served as Speaker Pro Tempore. Video link here.

    “Thank you Mr. Speaker pro-tem.

    Ladies and gentlemen of the House, I rise this evening to speak to an issue of great importance to me, and to the people of the state of Maine.

    Speaker of the House Mark Eves gives a rare speech from the floor, urgung members to join him in support of LD 1546, "An Act To Strengthen Maine's Hospitals, Increase Access to Health Care and Provide for a New Spirits Contract"

    Speaker of the House Mark Eves gives a rare speech from the floor, urgung members to join him in support of LD 1546, “An Act To Strengthen Maine’s Hospitals, Increase Access to Health Care and Provide for a New Spirits Contract”

    I rise to speak in favor of the pending motion to accept the majority ought to pass as amended report, and by doing so, accept a comprehensive measure that would make a final payment on Maine’s hospital debt and reduce future hospital costs by accepting federal health care dollars to cover tens of thousands of Mainers.

    Today lawmakers have an opportunity to pay back the debt owed to our hospitals and contain the rising costs of health care for our people and our hospitals.


    We have an opportunity together to do three things in one bill:

    Help our hospitals, help working Mainers who need health care, and help our economy.

    For 4 years, I served on the Health and Human Services Committee where we would consistently hear about the amount of charity care and bad debt the hospitals absorbed and then shifted onto working families with insurance and onto Maine businesses.

    When people without insurance get sick, they often end up getting care in the emergency room — where it is the most costly, least efficient way of providing care. Just last year, the Maine Hospital Association reported that Maine hospitals provided $450 million dollars in charity care and bad debt.


    The hospitals can not afford this and neither can we!

    In the proposal before us, not only do we pay back our hospitals, but we also ensure that thousands of Mainers can see a doctor when they are sick. By doing so, we reduce the charity care costs and bad debt that are cost drivers for our hospitals. This is a win for our hospitals and for every family in Maine who has insurance today.

    For several months, we’ve talked about the nearly 70,000 Mainers, many of them who are working but can’t afford health insurance, who would be eligible for coverage under this legislation.

    The number is so large and has been repeated so often, it’s easy to forget what it actually means.

    We could cut the number of people in Maine without health insurance in half.

    Seventy thousand people: That’s equivalent to the population of Aroostook County. Or Somerset and Piscatiquis counties together.

    The county by county numbers are compelling.

    Residents and hospitals in Maine’s most rural counties have the most to gain.

    · In Washington: 2,601 people would gain health care;$9.3 million in economic activity

    · In Somerset: 3,590 people would gain health care; $12.9 million in economic activity

    · In Waldo: 2,629 people would gain health care; $9.7 million in economic activity

    · In Oxford: 3,806 people would gain health care; 13.7 million in economic activity

    · In Aroostook: 4,615 people would gain health care; 16.8 million in economic activity

    · In Piscataquis: 1,067 people would gain health care; $4.0 million in economic activity

    · In Franklin: 1,878 people would gain health care; $6.9 million in economic activity

    · In Knox: 2,317 people would gain health care; $8.6 million in economic activity

    · In Hancock: 3,235 people would gain health care; $12.9 million in economic activity

    · In Lincoln: 1,817 people would gain health care; $6.6 million in economic activity

    · In Androscoggin: 5,829 people would gain health care; $20 million in economic activity

    · In Penobscot: 8,447 people would gain health care; $31.6 million in economic activity

    · In Kennebec: 5,997 people would gain health care; $20.8 million in economic activity

    · In Sagadahoc: 1,456 people would gain health care; $5.3 million in economic activity

    · In Cumberland: 12,018 would gain health care; $46.6 million in economic activity

    · In York: 8,196 would gain health care; $29.7 million in economic activity

    Now think of one of those 70,000 Mainers. Take Marie from Bangor. She has a part-time job that doesn’t provide health insurance. She also has a serious heart condition that doesn’t allow her to work full time. Without health insurance for her or her family, she is forced to choose between putting gas in her car and paying her medical and utility bills.

    This is not a hypothetical scenario. They are the hard facts for too many Mainers. And THIS is an ethical and moral dilemma for all of us.

    Unfortunately, Marie is one of tens of thousands of Mainers – many of your constituents – who are unable to afford health insurance.

    The personal stakes are high for thousands of people who could receive life-saving access to health care. But there is also a tremendous opportunity for our entire state.

    The Maine health care economy is the largest single job provider in the state of Maine. Healthcare jobs account for 1 in 4 jobs in Maine. By accepting these federal health care dollars we will inject $250 million dollars into our health care economy, creating more than 3,000 jobs.

    It is estimated that Maine hospitals would receive $163 million each year in additional revenue if we were to accept the federal dollars. This will help alleviate the current burden hospitals are facing and make sure we prevent future debt from accumulating so that we avoid a situation like this in the future.

    Maine’s hospital debt is a symptom of our high health care costs.

    This comprehensive measure pays the debt and helps fix the underlying problem that contributes to high health care costs in the first place. We don’t just treat the symptom; we treat the problem.

    The federal government has agreed to fully cover the cost for health care for tens of thousands of Mainers for the next three years, and gradually lowers its payment to no less than 90 percent of the cost over a decade. There is no cost to the state — in fact, we will save money.

    Maine is projected to save $690 million in the next 10 years if we accept the federal dollars, according to the nonpartisan Kaiser Foundation. These numbers are also confirmed by the conservative Heritage Foundation.

    We are one of 10 states that will actually see our Medicaid expenditures go down!

    If we want to save money in our Medicaid account, which I believe we all do, we must accept these federal health care dollars.

    This could change the lives of tens of thousands of Maine people who fear getting sick because they can’t afford to see a doctor when they need it most.

    Accepting these federal funds to increase health care coverage for more working Mainers is morally and economically the right thing to. And it makes sense to do it as part of a comprehensive package that repays Maine’s hospital debt. It both addresses the costs of health care for our hospitals and our people. To do one without the other, would leave the job half done.

    It’s a good deal. One we cannot walk away from!

    That’s why Republican governors across the country have sized up the proposal and have decided to accept the funds.

    Republican Governor Jan Brewer of Arizona has said turning away federal Medicaid dollars would increase human suffering and further cripple hospitals and other health care providers that care for the uninsured.

    Gov. Brewer recently said, “Being governor is tough — you have to make tough decisions and you have to look at the whole state, you have to do what’s right. Without expansion, “we would’ve had to go in and get people off of Medicaid, they would still be in our hospitals, you would still be paying for them.”

    Gov. Brewer’s bill to accept these federal dollars is accurately called the Arizona Health Care Cost Containment Measure. Gov. Brewer gets it!

    In New Jersey, Republican Governor Chris Christie has made a similar case:

    He said in a speech before the legislature unveiling his budget. “It’s simple. We are putting people first.”

    “Expanding Medicaid is the smart thing to do for our fiscal and public health” and will “ensure New Jersey taxpayers will see their dollars maximized.”

    Gov. Christie gets it!

    This should not be a political issue. We all agree we should pay the hospitals.

    But we are at an impasse over health care for tens of thousands of Maine people.

    The members of this body have a choice to make. Will you support a plan that pays the hospitals and accepts federal health care dollars to cover more Mainers? Or will you chose to deny and delay health care for tens of thousands of Maine people — putting politics ahead of the people’s health and our hospitals?

    I urge you to see this for what it is — a compromise that would benefit the state as a whole.

    This is how state government should function.

    In a divided government, neither party can get anything done by demanding all or nothing.

    I urge you to join me in supporting the pending motion. Now is the time to act.

    Thank you.”

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Maine Senate Republicans Floor Speeches Opposing LD 1546: “Washington Politics” and Mixed Messaging on Medicaid Expansion

Posted on May 26, 2013. Filed under: Uncategorized | Tags: , , , , , , |

(UPDATED: Links to more GOP floor speeches from the follow day’s second reading in the Senate are now found at the bottom of this original post. ~AP)

lepage veto 1546Originally, the intention was to simply share the various clips taken of the LD 1546, “An Act To Strengthen Maine’s Hospitals, Increase Access to Health Care and Provide for a New Spirits Contract” floor debates in the Senate and House as stand-alone posts without comment. Then a funny thing happened: in reviewing them, a clear separation of messaging became apparent between the members of the GOP in the Senate and the Governor’s “Office Du Jour” (see: Washington Post, Huffington Post, Talking Points Memo).

So, let’s take a look.

First Reading in the Senate, 5/20/13

Consistent GOP themes: LD 1546 is “Washington Politics”, “Welfare expansion”, myriad concerns over costs and having to hire either 83 new people (per Senator Mason) or 93 new people (per Senator Thibodeau) and general distrust of the federal government.

(Side note: If a business were to open in their district with 83-93 new jobs, Mason and Thibodeau would loudly cheer and claim “this was proof that Governor LePage’s policies work to help business.” Sigh…)

In short, everything Maine rejected from this party in the November election results.

So let’s go to the clips:

1. Senator Garrett Mason (Androscoggin)

    (:36) “… back room, Pelosi-style, Washington politics on full display, in the State House.”
    (:50) “… LD 1066, (“An Act To Increase Access to Health Coverage and Qualify Maine for Federal Funding”)is a massive welfare expansion that will cost Maine untold millions of dollars, not only over the next year, but over the life of the program.”
    (2:20) “… welfare expansion
    (2:47) “… So, what is this bill? Well, it’s a massive welfare expansion, to seventy thousand people…”

Perhaps some of the greater moments of irony came at the 1:20 mark, when Senator Mason claimed that the bill’s creation and process was “rude and disrespectful” of the VLA Committee and then further comments (2:00) that LD 1546 “was ram-rodded through”.

Um… anyone else remember LD 1333/ PL 90 from the 125th Legislative session? When Republicans openly admitted that they had not even read the bill? The bill that really WAS “ramrodded through”?

Republicans also claimed that it would pay for Maine’s 133,000 uninsured citizens and lower insurance costs. Um- not so much.

Onward.

2. Assistant Minority Leader Senator Roger Katz (Kennebec), Part 1

    “Linking these two bills together that have nothing to do with one another is just what people complain about when they see it happening in Washington. Unfortunately, that kind of strong-arm politics has migrated north.

    Governor LePage is in the middle of negotiations with the federal government to try to get us a better deal on Medicaid expansion. Maybe he will be successful and maybe he won’t. But if he is, that could save the state tens of millions of dollars. If we say yes to Medicaid expansion now, we lose our negotiating leverage.”

An ongoing “negotiation” since last July that has gotten Maine nowhere… nor this past March, when the Governor demanded a ten year waiver rather than three- something no other state has been granted by the federal government. In fact, Maine is no closer that it was in February 2012. Not exactly working to close the deal but rather putting off as long as he can.

Again- onward.

3. Senator James Hamper (Oxford)

Summary: Senator Hamper is concerned with the costs, especially in light of the reported DHHS shortfalls, inabilities to pay their bills past June 12th and budget projections for FY 14-15. Yet he urges that Maine not “rush through” with Medicaid expansion. Shame that the Governor thinks that “The Administration has not been entertained”and is now putting an unilateral gag order onto any within his administration that would go before the Appropriations committee to speak regarding the proposed budget and that he and he alone will be the one to speak to the committee.

    (5:48) “Slow down.
    (6:00)“We’re saying, ‘Don’t play Washington politics‘…”

As Hamper concluded: “Fool me twice… shame on me.

Indeed.

4. Senator Doug Thomas (Somerset)

“Charlie Brown’s football being hauled away by Lucy”. Um, okay. Not even gonna touch this one.

5. Senator Brian Langley (Hancock)

Now here is where it gets interesting- until this point, all of the GOP lawmakers have been on the same page of “Washington politics” and together poo-pooed the idea of expanding Medicaid at all. But at the 0:45 mark, we hear this from Senator Langley, who urges the bill be separated, rather than simply voted down- a far different position than all of the other Republicans that have spoken before him:

    “… because I am not opposed to it. What I am opposed to is the way it is being done here today.”

Interesting… and contrary to what Governor LePage said when he vetoed LD 1546.

    “Democrat leadership has spent the past week forcing this bill through the legislative process, over the objections of Republicans and Democrats alike. This unadulterated partisanship tied two different issues together in a quest to force welfare expansion upon the Maine people. I have said all along this bill would receive a veto when it reached my desk, so this letter should be no surprise.

    That is why I have filed a Governor’s bill today reflecting the parts of LD 1546 we all agree on—paying the hospitals and ensuring the liquor business provides the best return for the state—without the forced expansion of MaineCare. The Legislature will have the opportunity to vote up or down to pay the hospitals—I trust you will do the right thing.”

6. Minority Leader Senator Mike Thibodeau (Waldo)

Assistant Minority Leader Thibodeau, same as Rep. Ken Fredette would do later in the House, attempts to delay the vote with a series of procedural questions regarding the bill’s formation and combining of separate elements. Senate President, as Speaker of the House Eves would also do later in the session the next evening, explained his ruling. Thibodeau then speaks, first complaining on timelines elapsing in what he feels is a premature time frame, and then referring to items that the Democrats claimed were ramrodded through in the 125th Legislature.

He then quoted this PPH article penned by Maine Hospital Association president Steve Michaud:


    “Medicaid expansion is a centerpiece of the federal Affordable Care Act. While hospitals support the Medicaid expansion, we vehemently disagree that the expansion should be tied in any way to whether or not the outstanding bills get paid. Hospitals don’t control whether MaineCare gets expanded; they shouldn’t be punished if the expansion fails.”

What he failed to read was the following paragraph by Michaud:

    “This kind of leveraging of one issue versus another issue is bad policymaking. It is a common tactic in Washington, D.C., and one of the hallmarks of its dysfunction.”

And at the 5:10 mark, Thibodeau echos the phrase “Washington style politics”.

Wait, five “Washingtons”? BINGO!!

Oh wait… one of them was from the PPH article. Maybe we’ll get lucky with the next speaker.

7. Assistant Minority Leader Senator Roger Katz (Kennebec), Part 2

We already got Senator Katz down for a “Washington” mention. But we can add the good Senator from Kennebec as now a second supporter of Medicaid expansion! Note the 2:25 mark:

    “Personally speaking for myself, I have an open mind on the expansion.”

Moving along.

8. Senator Pat Flood (Kennebec)

Well, well! Add another senator who thinks (0:40) that expanding Medicaid is a good thing! His issues are similar to Senator Langley’s in that he would prefer the bills be examined and worked upon separately.

9. Senator David Burns (Washington)

(2:10)

    “Don’t be guilty of Washington politics.”

We even get a bonus, just to be sure (2:20)!

    “…don’t get caught up in the process of Washingtonian politics.”

Okay, there it is. BINGO!

Second Day Floor Speeches

1. Senator Pat Flood (Kennebec)

2. Senator Garrett Mason (Androscoggin), Part 1

3. Senator Garrett Mason (Androscoggin), Part 2

4. Asst Minority Leader Senator Roger Katz (Kennebec) Part 1

5. Senator Garrett Mason (Androscoggin) Part 3

6. Senator Andre Cushing (Penobscot)

7. Asst Minority Leader Senator Roger Katz (Kennebec) Part 2

8. Minority Leader Senator Mike Thibodeau (Waldo)

9. Senator Doug Thomas (Somerset)

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Maine Governor Paul LePage Vetoes LD 1546, Medicaid Expansion Bill (Video)

Posted on May 24, 2013. Filed under: Uncategorized | Tags: , , , , , , , , |

At a Hall of Flags ceremony surrounded by GOP legislators, Governor LePage on Thursday signed the letter to veto LD 1546, characterizing LD 1546, “An Act to Strengthen Maine Hospitals, Increase Access to Health Care and Provide for a New Spirits Contract,” as “tied payment of the hospital debt to welfare expansion” and then announced plans to reintroduce his own bill in its place.

    “Democrat leadership has spent the past week forcing this bill through the legislative process, over the objections of Republicans and Democrats alike. This unadulterated partisanship tied two different issues together in a quest to force welfare expansion upon the Maine people. I have said all along this bill would receive a veto when it reached my desk, so this letter should be no surprise.

    That is why I have filed a Governor’s bill today reflecting the parts of LD 1546 we all agree on—paying the hospitals and ensuring the liquor business provides the best return for the state—without the forced expansion of MaineCare. The Legislature will have the opportunity to vote up or down to pay the hospitals—I trust you will do the right thing.”

Press secretary Adrienne Bennett provided copies to the press of the letter the Governor read.

lepage veto lettr

The governor then informed those assembled of his plans to continue to hold the voter-approved bonds hostage unless his bill is passed through the Legislature, in what a press release categorized “a gesture of good faith”:

    The Governor also directed the State Treasurer to prepare the voter-authorized bonds for his signature. “I will sign them as soon as this new Governor’s Bill is enacted,” the Governor stated.
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Maine State Rep. Helen Rankin (D-Hiram) Speaks to Colleagues in Support of LD 1546: “From My Heart to Yours”

Posted on May 24, 2013. Filed under: Uncategorized | Tags: , , , , , , |

This floor speech (VIDEO) by Rep. Helen Rankin was not prepared in advance, but rather delivered from the heart from some notes, during Tuesday evening’s debate on LD 1546, “An Act To Strengthen Maine’s Hospitals, Increase Access to Health Care and Provide for a New Spirits Contract”.

100_5488In her address to her colleagues, Rankin speaks of being a child of the Depression, of losing her older sister at a young age due to the family’s inability to receive health care, of her mother working three jobs to provide for the family, of her own long life of good health and unexpected quadruple bypass this past year. She spoke of the wonderful life-saving treatment she received, due to being able to access health care, and concerns for those who do not have the same ability to access it as she and the House members can.

Her conclusion: “Please take advantage of this wonderful opportunity. I say that from my heart, to your heart.”

*Related:

Maine Speaker Of The House Mark Eves Urges Passage Of Medicaid Expansion Bill LD 1546 (Video; Text)

Floor Speech Of Rep. Drew Gattine (D-Westbrook) In Support Of LD 1546: Making The Case To Accepting Federal Funds

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Maine State Reps Sirocki (R-Scarborough), Malaby (R- Hancock) LD 1546 Opposition Speeches (Video; Text)

Posted on May 24, 2013. Filed under: Uncategorized | Tags: , , , , , , , |

(NOTE: Representative Heather Sirocki (R-Scarborough shared the texts of these prepared speeches last night on my personal FB wall; sharing here with the videos taken from the floor of the House. ~AP)

FLOOR SPEECH OF REP. HEATHER SIROCKI (R-SCARBOROUGH) (VIDEO)

    Mr Speaker, Ladies and Gentlemen of the House,

    I rise in strong opposition of the pending measure.

    Some may feel that combining bills from different committees is an efficient way to move forward, but the People of Maine are ill-served by considering legislation without input from the public.

    The question was posed, “ Is this bill properly before the body?”

    We were told that a public hearing was held. But I checked online, and found that no public hearings were scheduled.

    Before casting votes, most of us listen to testimony, read and research the issue, and consider the views of our constituents. I do not like being asked to pass bills first before I find out what is in them.

    LD 1546, the bill before us, did not follow the usual path of thoughtful consideration.

    The process of working this bill has been violated at its most basic level…two bills combined into one that did not receive any input from the public. As a matter of fact, there is not one piece of public testimony posted for this particular bill. Not one.

    There are, however, 69 documents of public testimony on the Medicaid expansion bill. But the Health and Human Services Committee is the only committee to have heard from the public regarding the expansion of Medicaid.

    I am very uncomfortable knowing that the sitting members of the Veterans and Legal Affairs committee, the committee of jurisdiction for this bill, have not had the opportunity to seek public input on this very important portion of LD 1546.

    Mr Speaker… How can we vote to move this bill forward when the process has been violated in this manner?

    Ramming a bill through a committee where the members did not have the opportunity to even read about the details, and where they did not hear even ONE minute of public testimony, is wrong.

    This violation of the process at the committee level is unacceptable.

    Regarding other reasons to vote No on this bill, let’s start with fiscal irresponsibility.

    Negotiating the liquor contract is time sensitive. If we miss the deadline, it will cost Maine’s hardworking taxpayers an additional $5 million. The clock is ticking.

    If we had paid our hospitals as the debt accrued, we would have been able to take advantage of a higher federal dollar match rate.

    My back-of-the- napkin calculations show that this delay has already cost us tens of millions of dollars.

    Thus, if we miss this deadline, that number bumps an additional $5 million.

    Let me repeat – tens of million dollars.

    Money that we could have spent towards services for … perhaps… disabled individuals who have been placed on waitlists.

    Mr. Speaker you are correct this is a moral and ethical issue.

    Mr. Speaker, I implore this body to recognize that the expansion of Medicaid is a separate bill with a separate timeline. Currently, that bill sits on the table in my committee- the Health and Human Services committee. The expansion should not be rushed. As a matter of fact, it is in Maine’s best interests to take our time, because rushing the expansion, may in fact, cost us more money, potentially, a lot more money. An audit is currently underway and is expected to be complete within a month. We do not have firm promises from the federal commission of health and human services yet.

    I urge each member of this body to think carefully before voting today.

    Please recognize that LD 1546 should go back to its roots. We need to bifurcate LD 1546. These are two separate bills, the one that was assigned to the Veterans and Legal Affairs Committee and the other bill to consider expanding Medicaid, which still sits on the table over in the Health and Human Services committee, where it rightfully belongs.

    For these reasons I cannot support LD 1546.

    We need to pay our hospitals now.

    We need to take our time negotiating with the federal government on further expansion of Medicaid.

    Two separate bills.

    Two separate time lines.

    Two separate votes.

    Thank you.

FLOOR SPEECH OF REP. RICHARD MALABY (R-HANCOCK) (VIDEO)

    Mr. Speaker, Ladies and gentleman of the House, I rise in opposition to the pending motion.

    As a member of the Joint Standing Committee on Health and Human Services, I would love to see that everyone in Maine with an Income below 138% of the Federal Poverty Level has true health insurance. It would likely save money for our health care providers and would hopefully improve health care outcomes. Who could not vote for that?

    Unfortunately that is NOT what we are voting on. The Medicaid Expansion under the Affordable Care Act is neither Health Insurance nor is it fiscally responsible for the state of Maine.

    Medicaid and our healthcare delivery system are clearly broken. And more of the same won’t fix it. Expanding Medicaid is the wrong prescription for a broken system and a faulty diagnosis invariably leads to the wrong treatment. Medicaid needs to be reformed prior to any expansion. We need to design a system that aligns consumer actions with societal goals while decreasing costs……… increasing access ……..and promoting quality. The bill before us will increase access at the expense of increasing costs and will do nothing to promote overall quality.

    I would gladly vote to reform Medicaid, a program designed in 1965 and rife with perverse incentives both for the consumers and the providers! I just can’t see how burdening the people of the state of Maine with hundreds of Millions of dollars of ongoing and future expenses for a program with no demonstrated efficacy in terms of health care outcomes is going to help anyone. At its very heart Medicaid encourages people to over consume and undervalue health care. With no copay or premium for health care in a system with unknown prices or information about quality is it any wonder that health care costs keep rising out of control? And isn’t that our real problem?

    Likewise Medicaid encourages providers to overbill for services. If patients are not paying for the health care services they receive, then they are unlikely to shop for quality and value. Consequently providers whether hospitals or doctors have no incentives to keep prices low in order to compete-as in any other market place- and hence the provider is incented to maximize their revenue and income based on the reimbursement model. Isn’t that why we owe our hospitals $484 Million for 2009 and 2010? And why is is that this bill requests $490.2 Million dollars when we owe the hospitals $484 Million? Is it the intent of the sponsors to repay the debt after October 1, thereby receiving $5 million less in FMAP match? Is that not irresponsible?

    The previous Medicaid expansions in which eligibility had been increased and optional services added currently costs the state of Maine $177 Million annually in General Fund dollars. Those who urged the past expansion of Medicaid promised it would reduce the number of the uninsured, reduce charity care, lower ER usage and have low and predictable costs. In reality health care costs have grown 4 times the rate of inflation, enrollment has exploded, there has been a gigantic increase in charity care and programs are now “capped” as the state has no money to pay for those seeking services. The state has even started to tax hospitals and nursing homes in pursuit of those federal dollars. I find that incredibly shameful.

    I support paying our hospitals that which we owe them. The state made a deal and the hospitals have lived up to their end of that bargain. I would support a true health insurance program for our low income population, but insurance is something you buy in a competitive market place where prices are known and competition is real and buyers shop based on value and price. I can’t support the poorly conceived expansion of Medicaid now being urged by so many. Expanding a financially failed program simply does not make sense.

    The hard working Maine taxpayers understand that we need to control spending. It is our job as legislators to prioritize our spending needs. What about all those people we currently have on waitlists for services who legally and morally deserve those services? The expansion will not address their needs. I am embarrassed by our inability to take care of the truly needy. Prioritizing spending during tough economic times requires leadership. For too long we have taken the easy way out by saying yes to more and more federal dollars. This has resulted in a never ending cycle of growing waitlists for our disabled population, increased pressure to repeatedly raise taxes, ongoing and annual supplemental budgets and crowding out of the true investments the state should be making. It is time to say no.

    Thank you Mr Speaker.

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Maine Senate Passes Historic Medicare Expansion, Hospital Repayment Bill LD 1546 Along Party Lines

Posted on May 21, 2013. Filed under: Uncategorized | Tags: , , , , , , |

Yesterday in a 20-15 vote, the Senate passed an historic measure to repay Maine’s hospital debt and accept federal funds to expand healthcare coverage for nearly 70,000 Mainers.

As passed, the bill (LD 1546) also makes the final payment to Maine hospitals, totaling $485 million in state and federal dollars. Maine hospitals will also receive an additional $163 million a year in federal dollars for treating newly insured Maine residents if Maine accepts the federal health care dollars.

100_5426Nearly 70,000 Maine people can receive healthcare coverage as soon as Maine accepts the federal government’s offer. The federal government has agreed to pay 100% of the cost for covering all newly eligible people for the first three years and then gradually lowering its payment to no less than 90 percent of the cost by 2020. Maine is projected to save $690 million in the next 10 years when it accepts the federal dollars, according to the nonpartisan Kaiser Foundation and the conservative Heritage Foundation. Maine is also one of 10 states that will see Medicaid expenditures go down over the next 10 years. Nearly 70 percent of Maine people support accepting federal health care dollars to increase access to health care, according to the nonpartisan Maine People’s Resource Center.

According to the Maine Hospital Association, both bad debt and charity care cost $450 million last year, an increase of $32 million from the previous year. Insuring nearly 70,000 Mainers will reduce hospital charity care and bad debt costs. The Maine Hospital Association has stated its support for paying back the hospitals and accepting federal health care dollars. According to the Maine Center for Economic Policy, accepting federal dollars would inject an additional $250 million of federal funding into Maine’s economy and create more than 3,100 jobs with more than 1,700 jobs in the healthcare industry alone.

During Monday’s debate, many Senators shared personal stories of people’s lives that will be impacted if the state accepts the federal government’s offer.

    “The time for delaying and denying healthcare to thousands of Maine people has passed. The time for action is now,” said Senator Margaret Craven of Lewiston. “Too many Mainers are one illness or accident away from financial ruin. It doesn’t have to be that way.”

    “Passing this bill is fiscally responsible, medically responsible, and morally responsible,” said Senator John Cleveland of Auburn. “The legislature can make that decision. We have it in our power to pay our debt to the hospitals and provide healthcare to the poorest in our communities.”

    Assistant Majority Leader Troy Jackson of Allagash spoke about two neighbors in his hometown who had health problems similar to his own. “Of the three of us, I was the only one with health insurance, I could afford to get the care I need, and I’m the only one who is alive. I can’t help thinking that’s the reason: I had health insurance. We should be throwing people like them a line, not pulling up the ladder behind us.”

    Senator Emily Cain of Orono reminded the body that, Fundraisers are not health care. People are not widgets. We must accept this offer.”

    “To be absolutely clear, medical insurance is not welfare. Medical insurance keeps people healthy. The patients who come to see me with insurance do much better than those without,” said Senator Geoff Gratwick of Bangor, who is also a practicing physician. “From my perspective as a physician, voting against this bill is a vote to cripple Maine, both literally and figuratively. Maine hospitals and Maine people both win with this bill. Maine’s hospital debt is a symptom of our high healthcare costs. Not only do we have to pay back our hospitals, but we have to address how we got here. By ensuring that thousands of Mainers can see a doctor when they are sick, we will keep the healthy at work. We will reduce the charity care costs and the debt our hospitals are accruing. To pay the hospitals without reducing their costs moving forward would leave the job half done.”

    “We are addressing the costs of health care for Maine people and hospitals,” said Senate Majority Leader Seth Goodall of Richmond. “What’s more, we’re doing it all in one fell swoop. That’s efficient. That’s good government. That’s what we were sent here to do.”

More clips in support of LD 1546 of Democratic Senators John Tuttle of Sanford, Chris Johnson of Somerville, John Patrick of Rumford (Part 1) (Part 2) and Independent Dick Woodbury of Freeport.

The bill, LD 1546, “An Act To Strengthen Maine’s Hospitals, Increase Access to Health Care and Provide for a New Spirits Contract,” faces additional votes in the House and Senate.

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UPDATED w/UStream Coverage: Emergency Appropriations Committee Meeting TODAY on LePage, Mayhew “DHHS Broke in 3 Weeks” Claims

Posted on May 19, 2013. Filed under: Uncategorized | Tags: , , , , , , , , , |

(Fingers crossed that this UStream works; first attempt at live event feed. ~AP)


Link to our new UStream Channel.

AFA emergency session agenda

AFA emergency session agenda

In light of the news late Friday that despite multiple supplemental budgets for FY ’12-13, DHHS doesn’t have enough money to pay its bills (again), an emergency meeting for the AFA committee has been called for today. Commissioner Mary Mayhew has been requested to appear to answer questions.

    lepage mayhewDemocratic leaders questioned why LePage sent a letter to them on a Friday evening rather than request a meeting to discuss the urgent news. Alfond and Eves also requested Mayhew appear before the Legislature’s budget-writing Appropriations Committee on Sunday to answer questions. The committee is holding weekend sessions as the Legislature’s June 19 adjournment date approaches.

    “The timing and intent of this letter is questionable,” Eves said in a prepared response. “It seems more geared toward fear mongering than problem solving. We have been pleased with the bipartisan work of the Appropriations Committee for the last five months. In order for their work to continue, we must get answers.”

    Alfond said Mayhew needs to “address the administration’s potential mismanagement of this situation.”

The committee was previously scheduled to work on the FY 14-15 budget today, but is adding time to speak with Mayhew about the letters sent out late Friday by herself and Governor LePage (see below). Among the possibilities is separating the change package presented last week from the FY 14-15 budget, a move that the administration appears reluctant to support at this time.

Here is a list of the committee members:

    Membership

    Senator Dawn Hill (D-York), Chair

    Senator Emily Ann Cain (D-Penobscot)

    Senator Patrick S. A. Flood (R-Kennebec)

    Representative Margaret R. Rotundo (D-Lewiston), Chair

    Representative Michael E. Carey (D-Lewiston)

    Representative Linda F. Sanborn (D-Gorham)

    Representative Megan M. Rochelo (D-Biddeford)

    Representative Aaron M. Frey (D-Bangor)

    Representative Erik C. Jorgensen (D-Portland)

    Representative Kathleen D. Chase (R-Wells) *

    Representative Tom J. Winsor (R-Norway)

    Representative Tyler Clark (R-Easton)

    Representative Dennis L. Keschl (R-Belgrade)

    *Ranking Minority Member

Audio link here. Fingers crossed, I hope to have this live streaming video feed up and running as well.

DHHS Commissioner Mary Mayhew letter to Governor LePage

Governor LePage letter to Democratic Leadership:

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Weekly Democratic Address by Rep Linda Sanborn (Gorham): Governor LePage Should Sign Our Comprehensive Plan to Pay Maine’s Hospitals

Posted on May 18, 2013. Filed under: Uncategorized | Tags: , , , , , , |

Audio link here.

linda sanbornIn the coming days, the state of Maine has an opportunity to pay back the debt owed to our hospitals and contain the rising costs of health care for our people and hospitals.

The Legislature will be sending Governor Paul LePage a bill to pay back Maine’s hospitals and to accept federal health care dollars to cover nearly 70,000 Maine people.

It’s an offer he shouldn’t refuse.

Good morning, I’m Representative Linda Sanborn – a retired family physician from Gorham.

Democrats have put forward a comprehensive plan that not only pays the debt; we make sure we don’t get back here in the future.

Maine’s hospital debt is a symptom of our high health care costs.

As a family physician, I can tell you first hand that when people without insurance get sick, they often end up getting care in the emergency room — where it is most costly. The cost of that care is often picked up by hospitals in the form of “charity care” and then passed on to anyone with private insurance.

By accepting federal health care dollars to cover more Maine families we reduce the charity care and bad debt that costs Maine hospitals $450 million dollars last year alone.

To do one without the other, would leave the job half done.

Our plan pays the debt and helps fix the underlying problem that contributes to high healthcare costs in the first place. We don’t just treat the symptom; we treat the problem.

The federal government has agreed to fully cover the cost for health care tens of thousands of Mainers for the next three years, and gradually lowers its payment to no less than 90 percent of the cost over a decade. There is no cost to the state — in fact we will save money. Maine is projected to save $690 million in the next 10 years if it accepts the federal dollars, according to the nonpartisan Kaiser Foundation.

This could change the lives of tens of thousands of Maine people who fear getting sick because they can’t afford to see a doctor when they need it most.

Take Marie from Bangor. She has a part-time job that doesn’t provide health insurance. She also has a serious heart condition that doesn’t allow her to work full time. Without health insurance for her or her family, she is forced to choose between putting gas in her car or paying her medical and utility bills.

Or, Patty Kidder of Sanford and her husband lost their health care coverage, like so many Mainers, when her husband lost his job at Spencer Press during the recession. Or, Tom Ptacek a U.S. Navy Veteran who works part time and has a non-service related problem that the VA doesn’t cover.

Marie, Patty, and Tom were among the many who urged lawmakers to pass this bill.

Unfortunately, they are not alone. This is a reality for tens of thousands of Mainers who are unable to afford health insurance.

Accepting these federal funds to increase health care coverage for more working Mainers is the right thing to. And it makes sense to do it as part of a comprehensive package that repays Maine’s hospital debt. It both addresses the costs of health care for our hospitals and our people.

It’s a good deal. That’s why Republican governors across the country have taken the funds.

Governor LePage has a choice to make: Will he support a plan that pays the hospitals and accepts federal health care dollars to cover more Mainers? Or will he retreat into an ideological corner, putting politics ahead of the people’s health?

People’s lives are on the line. Now is the time to act.

Thank you for listening. I’m Rep. Linda Sanborn.

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