Mayhew to discuss Medicaid expansion with Florida senators

Mary Mayhew at a news conference

BDN photo by Matthew Stone

Update appended

Maine Health and Human Services Commissioner Mary Mayhew will speak to a Florida Senate committee Monday afternoon as policymakers in that state decide whether to expand Medicaid coverage under the Obama administration’s Affordable Care Act.

Mayhew is scheduled to join a presentation via Skype to lend a perspective on the impact of Medicaid expansion elsewhere in the country. Mayhew’s co-presenter will be Tarren Bragdon. Bragdon led the conservative Maine Heritage Policy Center until 2011, when he moved to Florida to head up the Foundation for Government Accountability, a counterpart organization to the MHPC. Bragdon also led Gov. Paul LePage’s transition team in 2010 before leaving the state.

According to a copy of Bragdon and Mayhew’s presentation, Mayhew will likely discuss Maine’s experience with expanding Medicaid coverage to childless adults in 2002 and subsequent Medicaid coverage expansions in the state using federal American Recovery and Reinvestment Act funding.

Bragdon will also discuss Arizona’s Medicaid expansion in 2000 that extended coverage to more parents and childless adults in that state using tobacco settlement money.

Mayhew’s presentation to the Florida Senate’s Select Committee on Patient Protection and Affordable Care Act comes as Republican governors in a number of states say they plan to participate in the Affordable Care Act’s Medicaid expansion despite their opposition to the Affordable Care Act.

Republican governors in Michigan, Arizona, Ohio, Nevada, New Mexico and North Dakota have recently announced plans to participate in the law’s Medicaid expansion. In Maine, LePage has rejected the expansion.

Update, 6:15 p.m.

Mayhew told Florida lawmakers late Monday afternoon that Maine officials underestimated the number of childless adults who would sign up for coverage  – and overall Medicaid costs to the state – when the state undertook a Medicaid expansion in 2002. In addition, she said, the state’s efforts to expand its Medicaid program didn’t ultimately reduce the number of uninsured residents.

“It’s safe to say we fell short of our goal to reduce the uninsured population by 20,000,” she said.

Mayhew said Maine had 136,000 uninsured residents in 2002 and 133,000 today. Over that time period, she said, the proportion of Maine residents covered by Medicaid has increased to one in four. That’s the fourth highest rate in the nation, according to the Kaiser Family Foundation.

Since the state has devoted resources to covering able-bodied, childless adults, Mayhew said, Maine’s Medicaid program has fallen short in providing services to disabled and elderly residents who are in greater need of services.

“Maine’s expansion has locked up valuable resources covering this population while disabled and elderly wait for critical services,” she said.

If Florida participates in the Affordable Care Act’s Medicaid expansion, she advised, the state should make it a priority to cover the disabled, as opposed to able-bodied, childless adults.

The LePage administration is facing a lawsuit from adults with autism and other intellectual disabilities who have been on a wait list for services dating back to 2008. LePage’s biennial budget proposal includes enough funding to move about 85 — of more than 1,000 — off the wait list for services.