This week a coalition of health care advocacy groups filed a lawsuit in Kennebec County Superior Court to force the Maine Department of Health and Human Services to comply with a voter-mandated law to expand Medicaid coverage to 70,000 low-income Mainers. The lawsuit follows Gov. Paul LePage’s decision last month to ignore an April 3 deadline to file its State Plan Amendment with the federal Centers for Medicare and Medicaid Services (CMS) so that eligible people can obtain coverage by July 2, as required in the law passed by nearly 60 percent of Maine voters last November. Among the petitioners are Maine Equal Justice Partners, Consumers for Affordable Health Care and the Maine Primary Care Association.

“The LePage administration is breaking the law,” said Jack Comart, an attorney with Maine Equal Justice Partners, in a statement. “People have a right to coverage starting in July, and the Department of Health and Human Services cannot ignore the law.”

Under the Affordable Care Act, the federal government will provide 94 percent of the Medicaid expansion funding in 2018, or $525 million, while the state must match it with about $54.5 million once the federal match drops to 90 percent in 2021, according to the Legislature’s nonpartisan Office of Fiscal and Program Review (OFPR). The office also estimates that Maine has enough resources budgeted to fund Medicaid until next May. But the governor says he won’t submit the plan to CMS until the Legislature provides the state share of Medicaid funding. A $3.8 million bill to fund the staff necessary to implement expansion is also being held up in the Legislature due to strong opposition from House Republicans.

And despite OFPR’s cost estimate, LePage insists the cost of expansion will be $97 million a year by 2021. And he has put up a lengthy list of conditions that must first be met before he will follow the law. The governor says he will oppose several funding options, including new taxes, using money from the state’s rainy-day fund, or “one-time funding mechanisms or budget gimmicks.” He has also said the state must first come up with $40 million to fund services for people with severe disabilities.



In its lawsuit, the coalition argues that the state can fund the administrative costs out of its projected revenue surplus of over $140 million.

“Gov. Paul LePage has claimed that he could not submit a State Plan Amendment without funding from the Legislature,” said James Kilbreth, the lead attorney on the lawsuit and a partner at Drummond Woodsum, in a statement. “Submitting a State Plan Amendment does not require funding from the Legislature. The administration has a responsibility and obligation to take the necessary steps to implement the law the voters passed.”

The lawsuit also names several Mainers who will face delays in obtaining “medically necessary and potentially life-saving health coverage” because the governor has refused to follow the law. Among the petitioners is Cassie Steimlosk of Raymond who can’t afford private insurance and has to devote all of her time to providing round-the-clock care to her “extremely disabled son.”

The suit also names Charles McDaniel of Waterville who earns $1,200 per month with his wife, but suffers from an untreated nerve problem in his hands that limits his ability to work more.

According to the suit, petitioner Ann Avery of Old Town gets by solely on worker’s compensation, but was denied MaineCare despite having a disability. The suit states that Avery would qualify for Medicaid expansion, but is forgoing medical care because she can’t afford to pay out of pocket.

“There are no excuses to deny health care to more than 70,000 Mainers,” said Kathy Phelps, a member of the leadership team for Mainers for Health Care, which spearheaded the referendum, at a rally in Augusta on Monday. “Some of the individual plaintiffs wanted to be here today but could not because they are in poor health. They are home, waiting to see a doctor, waiting to be well. Lives are on the line. It’s time to respect the vote and implement the law.”