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Judge orders Maine to enact Medicaid expansion after group sues for implementation

Expansion benefits include care quality and a reduction in uncompensated care costs.

Susan Morse, Senior Editor

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A Maine Superior Court judge has ordered the state to enact Medicaid expansion, after delays caused the group that got the citizen initiative on the ballot to sue for implementation.

Maine voters passed Medicaid expansion in November 2017.

Judge Michaela Murphy sided with the Maine Equal Justice Partners, which brought the lawsuit in April, and ordered Ricker Hamilton, commissioner of the Maine Department of Health and Human Services, to submit a state plan amendment to the U.S. Department of Health and Human Services.

Republican Governor Paul LePage had argued that the legislature hadn't approved funds for Medicaid expansion, as the state would have to pick up 90 percent of the bill to extend health insurance coverage to low-income adults under the age of 65 who qualified for assistance.

The LePage administration argued in a court filing that it couldn't implement voter-approved Medicaid expansion because without money dedicated for the action, the state Department of Health and Human Services "plainly lacks legal authority" to spend money on it.

The court said it recognized that it did not have the authority to require the legislature to appropriate funds, but it did have the right to interpret the law.

Judge Murphy said the court was not persuaded that the executive branch was excused from statutory obligations by the legislature's failure to follow through with legislative obligations, as defined by the executive branch.

LePage previously vetoed legislative attempts for the expansion of Medicaid in the state.

He has said he didn't want taxpayers footing the bill for  "able-bodied adults," regardless of how deep in poverty they're living, according to the Bangor Daily News.

Maine is among states that have applied for a federal waiver to require work requirements for able-bodied adults to receive Medicaid benefits. Waivers have been approved in four states, including neighboring New Hampshire, which has expanded Medicaid.

Medicaid expansion has been linked to a number of health and economic benefits over the past few years. A pair of studies recently published in the journal Health Affairs provided evidence that expanding the federal program has positive effects on both volume, and care quality, particularly in more rural areas.

Hospitals in states that have expanded Medicaid have shown lower uncompensated care costs, according to a recent report published by the Kaiser Family Foundation.

Twitter: @SusanJMorse
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