Complete Video Record of Maine House Debates LD 1487, “An Act To Implement Managed Care in the MaineCare Program”
In chronological order, here are clips from this week’s House floor debate on LD 1487, “An Act To Implement Managed Care in the MaineCare Program”. The bill passed the chamber, but as in the Senate last week, narrowly failed to garner a veto proof majority.
Whenever possible, the full text of the prepared remarks has been linked to each clip; for others, either direct quotes or summaries as provided by House Democratic legislative aides online has been shared.
HHS Chair Rep. Dick Farnsworth (D-Portland) Presents LD 1487
Rep. Corey Wilson (R-Augusta) supporting LD 1487
Rep. Deb Sanderson (R-Chelsea) opposing LD 1487 (pt 1)
Rep. Louis Luchini (D-Ellsworth) supporting LD 1487
Asst. Majority Leader Jeff McCabe (D-Skowhegan) in support of LD 1487 (full prepared remarks HERE)
Rep. McCabe thanks lawmakers for this bipartisan effort. “This bipartisan health care bill can make a different to 70,000 Mainers — Our friends, our family, our neighbors.”
Rep. Jeff McCabe on economic benefits of health care expansion: “Why not these jobs? Why not now? ”
Rep. Paul McGowan (D-York) supporting LD 1487
Rep. Paul McGowan on health problems he had: “I had that health experience with the security of health insurance. Everybody in this chamber has the security of health insurance.”
Rep. Paul McGowan: “Can you imagine living in a society where if your house caught on fire and you called the fire department, and they said I’m sorry, you don’t qualify?”
Rep. Helen Rankin (D-Hiram) supporting LD 1487
Rep. Helen Rankin: “Our veterans who have sacrificed everything. Do we really turn away from them? I think not.”
Rep. Rankin: “Who made us God to decide about the lives of these people who are so desperate? … I think it’s time for us to pay it forward.”
Rep. Heather Sirocki (R-Scarborough) opposing LD 1487 (pt 1)
Rep. Matt Pouliot (R-Augusta) supporting LD 1487
Rep. Matt Pouliot: “This bill is a valiant attempt to find a middle ground, incorporating many principles that are important to me. … I will be supporting this motion.”
Rep. Craig Hickman (D-Winthrop) supporting LD 1487, pt 1
Rep. Craig Hickman (D-Winthrop) supporting LD 1487, pt 2
Rep. Craig Hickman reading from a constituent letter: “Are we really going to let these people down and say tough luck you’re on your own?… We are a better nation than that. We are a more compassionate people than that.”
House Majority Leader Seth Berry (D-Bowdoinham) in support of LD 1487 (full prepared remarks HERE)
Rep. Seth Berry: “Health care expansion makes good business sense. There’s also the human cost of denying health care to 70,000 Mainers.”
Rep. Berry on his younger brother: “He is one of the most hardworking Mainers you’ll ever meet. He is one of the Mainers who fall into the coverage gap caused by our failure to expand health care.”
Rep. Bobbi Beavers (D-S Berwick) in support of LD 1487
Rep. Roberta Beavers : “In York County alone, about 82 hundred more people will gain access to health care. An additional $43 million will be spent each year on health care services by 2016, stimulating about $59 million in additional economic activity and 513 new jobs in my county.”
Rep. Amy Volk (R-Scarborough) opposing LD 1487
Rep. Anne Graham (D- N Yarmouth) supporting LD 1487 (full remarks here)
- “The argument that that everyone should go on the exchange is false. Yes, one can purchase an insurance plan for $50 per month with a $2,5000 deductable. When one makes less than $12,000 a year, this is an impossibility. Once again, lose your life or lose your livelihood. I ask, what choice would you make?
It saddens me deeply that this debate has become more about politics than about people.”
Rep. Dennis Keschl (R-Belgrade) opposing LD 1487
Rep. Dr. Jane Pringle (D-Windham) supporting LD 1487
Rep. Jane Pringle, a retired doctor on why she’s in the Legislature: “I have watched the number of patients without health care grow. I have seen too many patients who could not get the health care they need until they were in crisis.”
Rep. Pringle: “Imagine coming to me as your doctor with chest pain. And I say, ‘Have you worked hard enough today for me to give you health care?'”
Rep. Pringle on the lack of belief in a system that will increase access, lower costs for all and save lives: “We have the power to do this. We just have to make this choice.”
Rep. Paulette Beaudoin (D-Biddeford) supporting LD 1487
Rep. Richard Malaby (R-Hancock) opposing LD 1487
Rep. Josh Plante (D-Berwick) supporting LD 1487
Rep. Dr. Ann Dorney (D-Norridgewock) supporting LD 1487
Another patient of Rep. Dorney lost health coverage, ran out of insulin and ended up in the ICU with dangerously high blood sugars. The hospital gave her some insulin when she was well enough to leave.
Rep. Bernard Ayotte (R-Caswell) opposing LD 1487
Rep. Sheryl Briggs (D-Mexico) supporting LD 1487
Rep. Lisa Villa (D-Harrison) supporting LD 1487
Rep. Brian Jones (D-Freedom) supporting LD 1487 (full prepared remarks HERE)
- Rep. Brian Jones on health care needs in the community: “The collection plate in church and the donation jar in the store have demonstrated they cannot completely fulfill this purpose. Nor can directives to get a better job.”
Rep. Dr. Janice Cooper (D-Yarmouth) supporting LD 1487
Rep. Gay Grant (D-Gardiner) supporting LD 1487
Rep. Steve Moriarty (D-Portland) supporting LD 1487
Rep. Tom Longstaff (D-Waterville) supporting LD 1487
Rep. Nate Libby (D-Lewiston) supporting LD 1487
Rep. Katherine Cassidy (D-Lubec) supporting LD 1487 (full prepared remarks HERE)
Rep. Katherine Cassidy about constituent with cancer: “They already put a portion of cancer treatment on their daughter’s credit card.”
Rep. Diane Russell (D-Portland) supporting LD 1487
Rep. James Campbell (U-Newfield) supporting LD 1487
Rep. Heather Sirocki (R-Scarborough) opposing LD 1487 (pt 2)
Questions posed through the Speaker during LD 1487 floor debate
Rep. Dick Campbell (R-Orrington) opposing LD 1487
Rep. Karen Kusiak (D-Fairfield) supporting LD 1487
Rep. Drew Gattine (D-Westbrook) supporting LD 1487
(UPDATED) Weekly Address of Governor Paul LePage, er, DHHS Commish Mary Mayhew: “Most Vulnerable Will Keep Paying the Price for Medicaid Expansion”
(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:
- 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
Hello, this is Maine Department of Health and Human Services Commissioner Mary Mayhew.
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.
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.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.
Video of DHHS Commissioner Mary Mayhew after the HHS Committee hearing on the Alexander report:Read Full Post | Make a Comment ( None so far )
(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.
Democrats released more information on the proposal and statements from leadership:
Democratic Leaders Issue Statement on Republican Health Care Expansion Proposal
- 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.
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:
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“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.
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:
— Dan Demeritt (@DemerittDan) February 25, 2014
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:
— David Sorensen (@DSorensenME) February 25, 2014
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.Read Full Post | Make a Comment ( None so far )
Yesterday the 126th Maine Legislature reconvened to begin the second half of the legislative session. At the same time, hundreds of people from around the state came to Augusta to hold a rally organized by Maine People’s Alliance coalition members, hear the life stories of almost two dozen fellow citizens, and urge lawmakers to support expansion of Medicare for 70,000 Mainers as part of the Health Care First initiative.
Almost two dozen came to the mic to speak at the rally; here is a full clip from the event held in the State House’s Hall of Flags.
- “As a nurse, many of the patients I see every day wait until they are so sick that we can’t help them the way that we should and their health deteriorates even more,” said Jessie Mellott, a Registered Nurse from Bangor, introducing the speakers. “They lose limbs. They may never get back to their previous health due to lack of access to care. A lot of the time, these are easy things to fix if they were addressed in time. I urge the legislature to help me care for my patients and take the important step of expanding Medicaid services for 70,000 Maine people.”
“When I found out I had seriously aggressive cancer I was able to access MaineCare and that was life-saving for me,”said Laura Tasheiko of Northport. “I was dropped and left without coverage as I continue my recovery from the ongoing and debilitating effects of cancer, surgery, and chemotherapy treatment. MaineCare is essential for the monitoring and care needed to avoid a medical crisis from medication complications, or even death, in the event of the cancer coming back.”
“Without MaineCare, my injuries will just keep getting worse and worse. I’ll just keep going until I can’t go anymore and then they’ll throw you to the wolves, I guess,”said Richard Holt, a lobsterman and carpenter living in South Portland, “I need it to make sure I can stay healthy enough to keep working for at least another 4 years before I qualify for Medicare.”
More quotes from Bangor Daily News:
- One of those speakers was Gail MacLean, who boards horses at her stable in Gray. MacLean said she has been on Medicaid for three years, but lost her coverage on Dec. 31 as a result of the state not expanding the program, known as MaineCare in the state.
“Now I’m tip-toeing around the farm, hoping I don’t hurt myself,” she said. “My fear is that if something happens, I’ll lose what I’ve worked so hard for.”
Another man, Tom Bennie, a farmer and handyman from Whitefield, said MaineCare paid for his full hip replacement in 2010, and helped his wife recover from a heart attack shortly thereafter.
“If it weren’t for MaineCare, I wouldn’t be able to stand here today,” he said. “My health is all I have. That’s the most important thing. MaineCare gave me a sense of security.”
Rep. Jeffrey Evangelos, I-Friendship, is co-sponsor of Eves’ Medicaid expansion bill, which legislative Republicans and LePage have vowed to defeat again this year. He called on the governor to follow the example of other GOP executives, such as New Jersey Gov. Chris Christie and Arizona Gov. Jan Brewer, who in their states accepted Medicaid expansion as allowed by President Barack Obama’s Affordable Care Act.
He called the showing by MPA “impressive.”
“I think it’s a real statement to the moderate Republicans to get on board,” he said. “If Gov. LePage vetoes this bill again, I expect them to support us in overriding.”
Later after the end of the beginning day of session, Senate President Justin Alfond and Speaker of the House Mark Eves spoke to those assembled:
- “Today in the halls of the State House, we heard why expanding health care to tens of thousands of Mainers is a top priority. The stakes are high—people’s lives and well-being are on the line,” said Senate President Justin Alfond of Portland. “Expanding healthcare is the right thing to do morally and it’s the right economic decision. Making sure folks have access to healthcare without the fear of going bankrupt is something we all value and it’s something we will continue fighting for.”
“We are so grateful to the people who came today to talk to lawmakers about the importance of this life-saving health care,”said Speaker of the House Mark Eves of North Berwick, who is sponsoring a new measure to accept federal Medicaid dollars under the Affordable Care Act. “What we heard today is what we hear from our neighbors at home: people want and need life-saving health care. They don’t understand why politics and ideology are holding up common sense care.”
A public hearing will be held by the HHS Committee (Cross Building Rm 209) on January 15 regarding Speaker Eves’ and Senate Majority Leader Troy Jackson’s Medicaid expansion proposals. More pictures from yesterday can be found here.Read Full Post | Make a Comment ( None so far )
NOTE: Continuing to dust off past posts regarding Maine Senate Minority Leader Mike Thibodeau (R-Waldo), as news broke today that he is considering jumping into the GOP primary race for Mike Michaud’s open seat. Here is the clip linked below in the original write up.
*Related: “Maine Senate Floor Debate On Override Of LePage LD 1509 FY 14-15 Budget Veto (June 26 VIDEOS)”
(Originally posted 18 Jun 2013)
Last week saw a clear division among the 126th Legislature’s GOP caucus regarding whether or not to pass LD 1066, “An Act To Increase Access to Health Coverage and Qualify Maine for Federal Funding”, as Assistant Minority Leader Sen. Roger Katz (R-Kennebec) proposed a “sunset provision” amendment that passed that chamber by a 23-12 vote.
Rising to speak against the provision were Minority Leader Sen. Mike Thibodeau (R-Waldo), Sen. Doug Thomas (R-Somerset) , Sen. James Hamper (R-Oxford) , Sen. Garrett Mason (R-Androscoggin) , Sen. David Burns (R-Washington) and Sen. Andre Cushing (R-Penobscot) .
Over in the House, Rep. Deb Sanderson (R-Chelsea) offered a second amendment to the bipartisan Senate approved bill, adding a $100 million dollar fiscal note that was indefinitely postponed by a 88-61 vote.
From her prepared testimony: (shortened dramatically, due to available working space on this post. ~AP)
“I rise before you today and present an amendment to LD 1066. This amendment seeks to set a clear and distinct priority in our MaineCare program and ensure that its original mission of caring for those who cannot care for themselves is fulfilled….
Today I speak for the people that we legislators, policy makers and budgeters have shoved into the shadows. Today I’d like to bring them out in the light for you to see. Yes, these are the 3100 people being forced to languish on a waitlist, not receiving essential services because we don’t have the fiscal discipline to make the choices that need to be made in order to fund the care they need… not want… need. Some have been on this list for years….
This amendment tried to rectify the abuses committed by the legislature and asks that you vote to insist that they begin receiving services by July 1 of THIS year….
Yes, it will be expensive. This amendment carries a fiscal note of almost $100 million dollars over the upcoming biennium….”
Her colleague Rep. Heather Sirocki (R-Scarborough) rose to speak in support of the amendment:
Then Minority Leader Rep Ken Fredette (R-Newport) spoke in strong opposition, not just to the amendment but to the Medicaid expansion bill as well.
(Later, Fredette would rise again to speak infamously out against the expansion- but, we’ve already covered THAT today!)
Asst Majority Leader Jeff McCabe (D-Skowhegan) then moved to indefinitely postpone the LD 1066 amendment.
When the House took the bill up again, as amended previously by Asst Minority Leader Senator Roger Katz (R-Kennebec), the vote results revealed some modest gains for the expansion, with 97 voting for enactment.
As expected, Governor LePage vetoed LD 1066 on Monday (now the second time he has vetoed Medicaid expansion), so now it awaits more votes in the Legislature.
Currently, House Majority Leader Seth Berry has moved for the bill to be tabled until later today (June 18) pending reconsideration.
Governor LePage Blames Treasurer Douglass, Dems for Bond Issuance Delays; Treasurer Says Not So Fast…
Governor LePage’s communication skills, and perhaps that of his office, continue to show need of some serious work.
So, let’s take it from the top.
First, the Governor publicly vetoed LD 1546 on May 24. Here is the letter, dated May 23, sent to the 126th Legislature.
Then last Friday (June 14), the Governor sent out the following press release. It needs to be noted that the stresses within the letter are exactly as released by LePage’s office:
- Governor Signs Hospital Bill, Makes Good on Promise to Maine People
AUGUSTA– After promising the people of Maine he would pay Maine’s hospitals, Governor Paul R. LePage has made good on that promise. More than 150 days after first introducing his plan to pay Maine’s $484 million in hospital debt, the Governor finally had the opportunity Friday to sign LD 1555 “An Act To Strengthen Maine’s Hospitals and To Provide for a New Spirits Contract.” He did so with little fanfare citing “it’s simply the right thing to do.”
“Paying our bills is the right thing to do, it’s just unfortunate that Democrats waited so long to make the right decision for the people of Maine,” Governor LePage said.
On January 15, Governor LePage announced his plan to pay $484 million in unpaid Medicaid bills – debt dating back to 2009 – to Maine hospitals. In March, Democrats proposed a “new” hospital plan, which was rejected in Committee. Democrats also claimed the Governor’s bill was unconstitutional before holding the bill up in Committee and refusing to allow a vote. Furthermore, Democrats tried tying Medicaid expansion to the hospital bill in late May, a strategy the Governor vetoed on May 23.
With $484 million debt erased, the Governor said he will issue voter-authorized bonds, including $51.5 million for transportation infrastructure improvements and $53.5 million for conservation, clean water upgrades, and construction and energy efficiency at post-secondary educational institutions.
In a letter dated May 23, Governor LePage requested the State Treasurer to start preparing those bonds for his signature.
“Lastly, as I have said all along, once we have our fiscal house in order, we will be in a position to release the authorized bonds. As a measure of good faith, I am hereby directing the State Treasurer to begin to prepare those bonds for my signature on an expedited basis. I will sign them as soon as this new Governor’s Bill is enacted. I hope she will act quickly to ensure our economy can get back to work,” he wrote.
The Governor has not yet received any information from the Office of the Treasurer.
Governor LePage has consistently said that it is irresponsible to issue new debt without a credible plan to pay the State’s outstanding debts.
Yesterday morning, Maine State Treasurer Neria Douglass sent out a press release of her own:
State Treasurer continues ready to prepare General Obligation Bonds; Calls on Governor to sign budget; Calls on Governor to sign TEFRA sign-offs
AUGUSTA — State Treasurer Neria Douglass stands ready to issue bonds that were authorized by Maine voters in June 2010 and November 2012 as she has been since being sworn in January 7, 2013. The first step in the process is receiving clear financial information on what is planned and ready. “Yesterday we asked agencies what projects are on deck. When we hear back, we can restart the investments that were stopped in June 2012.”
Yesterday, the Maine Information Statement (IS) on current finances and other fiscal matters was made public on the Municipal Securities Rulemaking Board (MSRB) website through the Electronic Municipal Market Access (EMMA) service. This information is used in preparing bonds, and is up to date right now.
“Interest rates are beginning to rise. I hope the Governor will encourage quick turnaround of information. And the construction season began weeks ago. I am ready when he gets us the information we need for sound financial planning,” (said Douglass).
The more time passes, the more work is required to update the Maine IS that is current through May 16, 2013, supplemented to May 30th, and is required to issue bonds.
The Maine Governmental Facilities Authority (MGFA) used the Maine IS to successfully issue lease revenue bonds that sold yesterday, June 13, 2013. The money will be used to complete the Augusta Courthouse and to renovate the Machias Courthouse. The Maine Judicial System asked to have the funds for immediate work in June 2013.
“When evaluating the actual repayment schedule, I saw that Maine would save $1.9M in FY 2014-2015 due to lower costs than originally estimated. I notified all members of the Appropriations committee last week. I love helping Maine and those working for positive change,” said State Treasurer Neria Douglass.
“I call on the Governor to quickly sign the budget just passed responsibly by two-thirds of the Legislature. The rating agencies and financial markets will not look favorably on his actions if he delays or vetoes it.”
Ratings on current outstanding bonds are set and will not change, but ratings on new issues could be negatively impacted by conflict between the Governor and the Legislature. “As I said in January, we can fix this by working together.”
Other projects in Maine are financed by moral obligation bonds that have also been held hostage by the Governor. They need his sign-off. The Maine Health and Higher Education Facilities Authority (MEHEFA), which funds education and hospital projects, and the Maine Housing Authority (MHA), which funds affordable housing projects, are two examples. The Tax Equity and Fiscal Responsibility Act (TEFRA) requires a sign-off, which is performed by the Governor in Maine. This is a ministerial duty he is required to perform just as the Treasurer is required to sign checks for bills that are properly due (In New York City, for instance, bonds of the New York Industrial Development Agency have a sign-off by the Mayor. See Step 6 at http://www.nycedc.com/nycida/application-process).
“Today I call on the Governor to sign the TEFRA notices that have been waiting since last fall. Let’s work together to get Maine back to work while interest rates are still low.”
The Governor has not written to the State Treasurer on these topics. In a veto message to the Legislature he mentions the State Treasurer.
“A veto message to the Legislature is not the right way to communicate with me,” said State Treasurer Neria Douglass. “I expect the courtesy of direct, respectful communication on the important financial needs and conditions of the State. Frankly, the ball is in his court, as we asked his people for information yesterday.”
A letter requesting more information from the Governor’s office yesterday morning has not yet (6pm June 18) received a response; the same letter got the following quick reply from Neria Douglass, with additional information.
“The Governor has not written to me. He sent an email copy of his veto of the first hospital payment bill that included accepting the federal Affordable Care Act MaineCare expansion. We asked what cash is needed to restart the projects he stopped last year.”
Neria R Douglass JD CIA
She sent a second email, moments later:
- “Someone on his staff sent a copy. I am ready. We, MGFA, sold bonds for the court house renovations in Augusta and Machias Thursday, June 13, 2013. We don’t bond until he has the projects ready to go.”
Neria R Douglass JD CIA
Among the information attached was a letter dated May 31 from the Treasurer’s office to Democratic leadership, outlining the status of the previously mentioned bonds.
Here are the emails sent back and forth between Treasurer Douglass’ office and that of Governor LePage:
1. Email from the Governor’s office to Treasurer Douglass
- Date: Thu, 23 May 2013 13:51:19 -0400
From: “Libby, Lance”
To: “Douglass, Neria R”
CC: “Cianchette, Michael”
Subject: LD 1546 Veto Message
“Dear Treasurer Douglass,
Per Michael Cianchette, attached please find the veto message for LD 1546. Please feel free to contact our office if you have any questions or concerns.
Legislative Policy Coordinator
Office of Governor Paul R. LePage
2. Letter from Acting Deputy State Treasurer to Carlton et al
From: Carlow, Kristi L.
Sent: Thursday, June 13, 2013 8:18 PM
To: Carlton, Aimee M.; Garland, Denise; Johnson, Deborah; Jean, Rosalyn R; Feinstein, Judith A.; Mckenna, Mike; Mohney, Kirk; DeHaan, Dirk; Cusick, Debi; ‘firstname.lastname@example.org’
Cc: Rodriguez, Timothy; Douglass, Neria R
Subject: Requests for Bond Funds
“Good evening. In preparation for the continuation of bond projects, please take this opportunity to review your anticipated FY14 cash needs for authorized bond projects. Using the attached spreadsheet, indicate your monthly estimates and forward it back to me as soon as possible, but no later than 6/21/13. You might want to contact your Budget Analyst soon to verify that you will have sufficient allotment when funds are released, as well.
Until we can evaluate departmental needs (from your responses), we will not know when it will be necessary to issue the actual bonds, but we anticipate the cash pool will have sufficient capacity to fund your cash needs for now. For those of you that will be requesting 018 Funds, I will send along the Departmental Certificate soon for completion.
Please let me know if you have any questions. Thank you!”
Kristi L. Carlow
Acting Deputy State Treasurer
Office of the State Treasurer
111 Sewall St., 3rd Floor
39 State House Station
Augusta ME 04333-0039
3. Follow up letter by Acting Deputy State Treasurer Carlow to same
Date: Fri, 14 Jun 2013 12:56:59
“Just to clarify, we are not moving forward at this point. This preliminary step will simply allow us to be slightly more prepared when the Governor allows projects to move forward. Thank you.”
Kristi L. Carlow
Acting Deputy State Treasurer
So, it doesn’t look like the delays are the fault of either the Treasurer nor that of Democrats- but rather that of the LePage Administration.Read Full Post | Make a Comment ( None so far )
Last week, the Maine Senate voted 23-12 on LD 1066 “An Act To Increase Access to Health Coverage and Qualify Maine for Federal Funding” which would expand healthcare coverage to nearly 70,000 low-income and working Mainers. Assistant Minority Leader Roger Katz (R-Kennebec) added a “sunset provision” amendment of three years to the bill, which was supported by himself and fellow Republican Senators Pat Flood (Kennebec) Tom Saviello (Franklin).
Earlier he expressed support for a stand alone version of Medicaid expansion, as did Senator Brian Langley (Hancock) and Pat Flood (Kennebec).
Many of the GOP caucus rose to speak in opposition, including Minority Leader Senator Mike Thibodeau (Waldo).
Senator Doug Thomas (Somerset)
Senator James Hamper (Oxford)
Senator Garrett Mason (Androscoggin)
Senator David Burns (Washington)
Senator Andre Cushing (Penobscot)
Democrats stood together and supported the now stand alone measure, as they had LD 1546 a few weeks ago.
“People’s lives are on the line. We must put politics aside and do what is right for the people of Maine,” said Senate Majority Leader Seth Goodall of Richmond (VIDEO). “We cannot be siloed in one belief or another. When you need health care you are not thinking about political party lines, you are trying to do what’s best for your health. We have an opportunity to get it done and help Maine people.”
“Building a strong economy and a strong middle class means making sure people have the health care they need, when they need it, at an affordable cost,” said Senator Geoff Gratwick of Bangor who is a practicing physician. “Accepting federal funds will strengthen Maine’s economy and provide health coverage to thousands of hard-working Mainers.”
“My philosophy is that everyone should have health insurance,” said Assistant Majority Leader Troy Jackson of Allagash (VIDEO). “If I wasn’t serving in this chamber, I would be one of the people covered under this act. I assure you I am able bodied, but without health insurance I would be 100% ruined at this point. The last operation I had cost more than $120,000. I won’t make that much money in six years. I don’t know what I would do if I didn’t have health insurance.”
Governor LePage’s office was quick to release a statement:
“I will not entertain any discussions about welfare expansion until these 3,100 disabled and elderly Mainers are taken care of,” the Governor said. “The Legislature has ignored the needs of these citizens for years, but now the Democrats want to expand welfare to able-bodied adults with no children. Not only is that bad public policy, it’s a disgrace.”
The Governor said his administration is still in negotiations with the federal government to get waivers that would allow the state to fix fraud and abuse within Maine’s welfare system. Welfare expansion would cost Maine millions of dollars annually if fraud and abuse in the existing system is not addressed.
“Until we crack down on the fraud and abuse that robs hard-working Mainers of their tax dollars, I will not discuss any efforts to expand welfare,” the Governor said. “We do not need to burden hard-working taxpayers with additional costs for those who are not disabled. The Democrats have to stop discriminating against the disabled and elderly and treat them fairly.”
The House will take up the bill later this week.Read Full Post | Make a Comment ( None so far )
(NOTE FROM ANDI: All of these clips were recorded the evening of May 21, 2013 in the House chamber and being shared unedited in chronological order. In the instances where a post has previously been written, a link to that write-up is being shared as well, as some lawmakers were kind enough to share their prepared statements.)
8. Rep Henry Bear (Maliseet) Speaks in Support of LD 1546
9. Rep Katherine Cassidy (D- Lubec) Speaks in Support of LD 1546
10. Rep Amy Volk (R-Scarborough) Speaks in Opposition to LD 1546
11. Rep. James Campbell (I-Newfield) Speaks in Support of LD 1546
13. Rep Janice Cooper (D-Yarmouth) Speaks in Support of LD 1546
14. Minority Leader Fredette, then Rep Wayne Parry (R-Arundel) Speak in Opposition to LD 1546
15. Rep Jane Pringle (D-Windham) Speaks in Support of LD 1546
17. Rep Adam Goode (D-Bangor) Speaks in Support of LD 1546
18. Rep Peggy Rotundo (D-Lewiston) Speaks in Support of LD 1546
19. Rep Lawrence Lockman (R-Amherst) Speaks in Opposition of LD 1546
20. Rep Dennis Keschl (R-Belgrade) Speaks in Opposition of LD 1546
Additional related links:Read Full Post | Make a Comment ( None so far )
(NOTE FROM ANDI: All of these clips were recorded the evening of May 21, 2013 in the House chamber and being shared unedited in chronological order. In the instances where a post has previously been written, a link to that write-up is being shared as well, as some lawmakers were kind enough to share their prepared statements.)
2. Minority Leader Ken Fredette (R-Newport) Proposes Dividing LD 1546
3. House Speaker Mark Eves (D-N Berwick) Rules on Division of LD 1546
4. Minority Leader Ken Fredette (R-Newport): “Die Has Been Cast; False Choice by Democrats”
5. Maine State Rep. Dr. Linda Sanborn (D- Gorham) Speaks in Support of LD 1546
6. Rep. Deb Sanderson (R-Chelsea) Speaks in Opposition to LD 1546 (Part 1)
Additional related links:Read Full Post | Make a Comment ( None so far )
ICYMI: Maine Speaker of the House Mark Eves Urges Passage of Medicaid Expansion Bill LD 1546 (Video; Text)
(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.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.
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