In what the monstrous Seema Verma, administrator of the U.S. Centers for Medicare and Medicaid Services, called a Christmas gift last week, Maine's outgoing Republican Gov. Paul LePage got the power to impose work requirements on the citizens of Maine who are Medicaid enrollees. In a late holiday gift to the people of Maine, the incoming Democratic Gov. Janet Mills won't have to implement them, say experts.
Health policy experts, like MaryBeth Musumeci, associate director of the Program on Medicaid and the Uninsured at the Kaiser Family Foundation, a national health-policy think tank, believe that she's free to choose not to go along with the waiver. She points to the precedent of Gov. Tom Wolf, Pennsylvania's Democratic governor who was elected in 2014. He ignored a waiver that had been granted to his Republican predecessor to restrict Medicaid expansion and implemented the expansion under the Affordable Care Act without any of the changes included in the waiver.
Chris Hastedt, public policy director for Maine Equal Justice Partners which helped get the Medicaid expansion onto the ballot as a citizens' initiative, agrees. The groups lawyers have studied the waiver and the law and conclude Mills does not have to implement the waiver.
For her part, Mills says she's waiting until legal experts evaluate what she can do, in light of the fact that similar work requirements have kicked almost 17,000 people out of the program in Arkansas, the first state to implement them. Mills will implement the Medicaid expansion voters approved, adding about 70,000 people to the program. "It's not whether I want to or don't want to," implement the waiver she said, "it's what the law says, and that's something we will be looking into in the coming weeks. […] I want some health care lawyers in my office and others to look at it more deeply before I can make a decision about what I can do with it and what I can't do with it. And how I can step back or not step back from it."
What a remarkable thing for the people of Maine. A thoughtful, responsible governor whose approaching the job like an elected executive is supposed to do.