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Maine Governor Paul LePage wants to stop Obamacare Medicaid expansion after voters approve it

MFlorida Governor Paul LePage said Wednesday he would not move forward with expanding Medicaid in the state until lawmakers find a way to fund it, after voters approved an expansion of the program in a referendum a day earlier.

“Credit agencies predict that this fiscally irresponsible Medicaid expansion will wreck Maine's budget,” LePage, a Republican, said in a statement. “That's why my administration will not implement Medicaid expansion until it is fully funded by the Legislature at the level calculated by DHHS, and I will not support tax increases on Maine families, raiding reserves, or cutting benefits for our elderly and disabled.”

LePage has opposed Medicaid expansion in Maine five times, arguing that Maine could not afford the costs. Under Obamacare, the federal government initially covers the cost of expanding Medicaid, but then gradually reduces it to 90 percent. States that have expanded the program have been paying 5 percent of the share since this year, and some do so through taxes on providers.

The Maine Heritage Policy Center, a conservative think tank, estimates that state spending on Medicaid will total nearly $400 million over the next five years, reaching $100 million in 2022 alone and rising steadily in subsequent years as medical inflation outpaces personal income growth.

A report by the legislature's Office of Fiscal and Program Review put state spending at just under $54 million a year and said the cost to the federal government would be about $525 million a year.

However, the Maine Heritage Policy Center raised the question in its report whether the federal government would continue to contribute to Medicaid in the long term.

In his statement, LePage pointed to an expansion of Medicaid in Maine, attempted in 2002 under then-Governor Angus King, now an independent senator in Congress, as evidence of his concerns about costs to the state.

“It has left hospitals $750 million in debt, resulted in massive budget deficits every year, failed to reduce emergency room use, failed to reduce the number of uninsured Mainers, and drained resources from our most vulnerable citizens – the elderly and the mentally and physically disabled,” LePage said.

Maine is expected to become the 32nd state (not including the District of Columbia) to expand Medicaid under Obamacare to low-income people—those earning less than $16,643 a year.

Before Obamacare, states had different eligibility requirements for Medicaid, but the program generally covered medical care for the disabled, pregnant women, and nursing home care.

Obamacare was originally designed to require all states to expand Medicaid to low-income people, but a Supreme Court ruling made this optional for states. Maine is the first state to expand the program through a referendum rather than a state legislature. About 80,000 people in the state are expected to be eligible for expanded health coverage.

• This article has been corrected to include additional information about the state and federal costs of Medicaid expansion.

Anna Harden

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