Politics
Our political journalists are based in the Maine State House and have deep source networks across the partisan spectrum in communities all over the state. Their coverage aims to cut through major debates and probe how officials make decisions. Read more Politics coverage here.
A long Tuesday in Augusta ended without a short-term budget deal between Democratic and Republican lawmakers, and a familiar issue was among the sticking points.
The key compromise that Democrats who narrowly control the Legislature and governor’s office are negotiating with Republicans before members return to the State House for a Feb. 25 vote is an annual limit on General Assistance that helps low-income individuals with housing, rather than Republican-backed Medicaid work requirements that Democrats do not support.
But President Donald Trump, who returned to the White House last month, could push for national requirements after backing state efforts to create them during his first term. MaineCare, the state’s version of the federal low-income health care program, has been the key word in prolonged negotiations over the supplemental budget that seeks to fill a $118 million MaineCare hole and offer $2 million to fight spruce budworm infestations.
Former Gov. Paul LePage, a Republican, stalled the Medicaid expansion that Maine voters approved in 2017 to cover those between ages 19 and 64 who are lower income. As LePage’s second term wrapped up in 2018, the Trump administration approved a waiver that briefly put Maine among the first seven states allowed to require many recipients each month to work 80 hours and pay up to $40 in premiums.
However, Gov. Janet Mills, a Democrat who ran on reversing many of LePage’s health policies, swiftly pulled the state out of the waiver upon taking office in 2019, saying it “would leave more Maine people uninsured without improving their participation in the workforce.”
The issue resurfaced Tuesday, when Democrats who initially had the support of several Republican appropriators on a short-term budget instead held off on enacting the deal after not receiving any GOP votes needed for it to take effect immediately rather than 90 days later. Republicans, apart from wanting a three-month General Assistance limit that Mills initially included, argued MaineCare costs are becoming increasingly unsustainable.
They proposed several amendments that Democrats voted down, including one from Senate Minority Leader Trey Stewart, R-Presque Isle, that would require the state to request a federal waiver to freeze MaineCare enrollment by “able-bodied, childless adults” and reduce enrollment by 10 percent, allowing “additional program integrity measures to ensure compliance.”
Stewart defended his amendment during a Tuesday evening floor debate by saying it would tackle the MaineCare funding gap and benefit “our local economies” by requiring people who are otherwise “quite literally not doing anything” to work, train or volunteer 20 hours a week.
“We’re not talking about something radical here,” Stewart said.
While Republicans are not in control of the State House, Trump’s budget director has mentioned making a national push for Medicaid work requirements. The comments from Office of Management and Budget Director Russell Vought, who won confirmation this month after U.S. Sen. Susan Collins, R-Maine, and Republicans backed him, could preview a more aggressive federal effort after it was left to states to apply for waivers during Trump’s first term.
“It’s informed not only Medicaid, but other programs, to be able to encourage people to get back into the work force, increase labor force participation and give people again the dignity of work,” Vought said last month, citing a 1996 reform law signed by Democratic President Bill Clinton.
Liberal groups have opposed work requirements by arguing they have not led to positive changes. Arkansas reportedly saw nearly 17,000 of the roughly 250,000 people in its program lose coverage near the end of 2018 after the addition of work requirements.
“It really just takes things away from people that they really need, like medical care and food,” Alison Weiss, spokesperson for Maine Equal Justice, which advocates for low-income people, said, adding it is not an issue of “motivation” but other barriers that can hamper people in need.
House Republicans on Capitol Hill also expressed support for Medicaid work requirements and other changes to slash spending while releasing their budget resolution this week and insisted they would not seek bigger cuts to the program serving more than 72 million Americans. The nonpartisan Congressional Budget Office has estimated work requirements could save more than $100 billion over a decade.
Health groups including the American Lung Association are also against Medicaid work requirements. Lance Boucher, the association’s assistant vice president of state public policy in the eastern division, said it is “not about work but about paperwork.”
“It’s a thinly veiled effort aimed at further restricting Mainers’ access to affordable, quality health care,” Boucher said.
