Emergency bill would restore full MaineCare payments to hospitals

May 7—AUGUSTA — A bipartisan group of Maine lawmakers launched a last-minute attempt Wednesday to free up $118 million in MaineCare payments to health care providers that were delayed until late June after a previous proposal collapsed.
But the emergency measure immediately faced an uphill climb. Senate Republican leaders continue to oppose the proposal, and an effort by House Democrats to skip the committee process and public hearings and move right to floor votes generated opposition from Republicans, including a co-sponsor.
House Speaker Ryan Fecteau, D-Biddeford, sought to fast-track the bill, which had three Republican co-sponsors, by suspending the rules that require bills to be referenced to a committee for a public hearing and work session before any votes by the full House or Senate.
The maneuver caught Republicans by surprise and prompted one of the Republican co-sponsors to object. A majority of the House members supported the bill, but it was sent to the Senate without the two-thirds support needed to enact the emergency measure and immediately provide the funding. The Senate did not take up the bill Wednesday.
"I'm sure there's a lot of confusion happening right now — I know for me there is as well since we were not told anything like this was happening," said Rep. Amanda Collamore, R-Pittsfield, a co-sponsor of the bill. "What is concerning to me is that we are usurping the tradition and the rules of our body by not allowing the public to have a chance to speak on a bill. ... I do not support this not being sent to committee and waiving those rules."
Fecteau, however, said Democrats were seeking to waive the rules because similar proposals have already received public hearings and been debated in committees and in each chamber has part of two separate budget bills, and he didn't want to consume valuable committee time or scarce resources, including nonpartisan staff time.
"The rationale was, if this bill was going to be introduced, it should just have an up-or-down vote, since the policy matter at hand has already been debated in both chambers," Fecteau said.
Initial votes in the House did not bode well for reaching the 101 votes needed to enact the bill as an emergency. The House voted 69-63 to waive the rules, and a Republican effort to kill the bill failed by a 85-55 vote.
Senate Republican leaders, who previously blocked an emergency bill to pay MaineCare providers, do not appear to have changed their position. Those senators demanded other reforms to MaineCare before supporting the funding. MaineCare is the state's version of Medicaid, the public health insurer for people with low incomes.
"Nothing has changed and the (D)emocrats are still not willing to reform a program that is completely broken," Senate Minority Leader Trey Stewart, R-Presque Isle, said in a text message.
The MaineCare funding is already included in a budget bill approved by lawmakers and signed by the governor. But the funding will not become available until June 20, because most Senate Republicans withheld their support, preventing the budget from taking effect immediately as an emergency measure.
In addition, there is also an effort to block the approved budget from taking effect through a people's veto campaign. If conservative activists secure the required signatures and file them with the state, the funds allocated in the budget will remain frozen until a statewide referendum in November.
Until the funding becomes available, health care providers are receiving reduced reimbursements for services they continue to provide — a scenario putting many providers and services at financial risk, especially in rural areas.
PROVIDERS EAGER FOR RELIEF
Jeff Austin, a spokesperson for the Maine Hospital Association, said his members are eager for financial relief — even if it's only by a few weeks.
"It's been very difficult," Austin said of the impact of curtailed reimbursements to his members. "It's a significant amount of money in a short period of time. So, shaving off even a couple of weeks of the pain would be helpful."
Rep. James Dill, D-Old Town, submitted the after-deadline bill to restore full MaineCare payments to health care providers as soon as the bill is approved by two-thirds of the Legislature and signed by the governor.
Dill said he brought the bill forward in response to concerns from constituents, including health care workers who are worried about layoffs and patients worried about the loss of services. He hopes to convince opponents to support his bill, which would allow health care facilities to access funding that has already been approved by the Legislature and endorsed by the governor.
"They realize the money is just sitting there," Dill said.
LD 1948 is co-sponsored by three House Republicans: Collamore and Reps. Amy Arata of New Gloucester and Dean Cray of Palmyra. But, even if House Republicans join Democrats in supporting the measure when it comes back form a second vote in that chamber, it still faces hurdles in the Senate. Republican leaders in the Senate have demanded a series of amendments that would cap enrollment and seek work requirements for able-bodied recipients, among other things.
House Republicans had already voted in support of the MaineCare funding during previous negotiations after winning a concession from Democrats to reform General Assistance, a safety net program that is mostly funded by the state.
"I just felt that with it passing once in the House we could just (act on) this one piece because everybody in there either knows somebody, has constituents or has facilities in their district that could be hurt badly by not getting this funding," Dill said.
Dill hopes to pick up the four votes needed in the Senate to reach the two-thirds threshold needed to enact the emergency measure and then win over House Republicans who objected to fast-tracking the bill.
"I will talk to a lot of (my co-sponsors) again and get them to go along with it," he said.
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