A bipartisan group of legislators is accusing the LePage administration of violating state and federal law by ending contract ombudsman services through the state Medicaid Managed Care program. The nonprofit Maine Consumers for Affordable Health Care was previously contracted to help consumers navigate the complex patchwork health care system of MaineCare, the health insurance marketplace and private insurance. 

“Contracts change all the time. I understand that. And the Department has an obligation to review contracts to make sure that the work they are paying for is needed and is getting done,” said Rep. Karen Vachon (R-Scarborough), who is also a health insurance agent, in a statement. “But the Department also has an obligation to follow the law and to take care of Maine residents. In this case, they are Maine residents who need help to navigate our confusing health care system to get coverage.”

Since 2006, the state has contracted with MCAH for the service, which is funded by a combination of federal and private matching dollars. According to MCAH, the outreach services are required by federal law and without it DHHS will have to invest more money to train personnel to perform the same service. The group argues that because of MCAH, fewer people go to DHHS with inquiries, as the organization handled questions related to free clinics, state benefits prescription assistance and hospital charity care. Calls to MCAH’s HelpLine reportedly increased six-fold in the past decade, from 1,622 in 2006 to over 6,700 in 2014.

“Last year, Maine families called the Consumers for Affordable Care helpline nearly 6,000 times because they were having trouble navigating a complex health care marketplace or because they couldn’t make progress with the Department of Health and Human Services,” said State Sen. Geoff Gratwick (D-Bangor) in a statement. “The ombudsman services CAHC has provided to our state, including this HelpLine, are critical to Maine families.”

Maine DHHS called the group’s criticism “nothing more than a thinly veiled political stunt orchestrated with the sole intent of getting CAHC another taxpayer-funded contract.”