Staff Report

Augusta – Senate Republican Leader Trey Stewart, R-Aroostook, submitted a proposal to address serious concerns with the sustainability and program integrity of MaineCare. The introduction of this measure comes after numerous cases of fraud and millions of dollars in overpayments have been found, including $45.6 million found in a recent U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG) audit.

Sen. Stewart’s proposal would require a third-party independent entity to review and assess current processes, procedures and capacity in place to identify waste, fraud and abuse. The plan would also mandate the Maine Department of Health and Human Services (DHHS) to submit quarterly progress reports to the Legislature to ensure MaineCare program compliance.

In addition to these program integrity measures, the policy would require compliance with federal work and community engagement requirements for able-bodied childless adults. The measure would also require an enrollment freeze and scale down for able-bodied childless adults until enrollment has been reduced by 10%.

In the current biennium, MaineCare will require an almost $170 million bailout. After last year’s bailouts, the Legislature will have plugged MaineCare by over half a billion dollars in the current biennial budget.

“MaineCare is the largest single item in our state’s budget and it only continues to grow. We must take steps to ensure the program can continue to provide services to those who need them most without requiring a massive bailout every legislative session,” said Sen. Trey Stewart, R-Aroostook. “MaineCare has a serious sustainability problem. It’s incumbent upon the Legislature to rein in this program by both reducing fraud and making sure healthy adults on the program can better themselves and get off taxpayer-funded healthcare.” 

“The legislative majority isn’t even thinking about how to make up for the tens of millions of dollars in Medicaid funds the federal government will likely be clawing back,” said Sen. Marianne Moore, R – Washington, Senate Republican Lead on the Health and Human Services Committee. “We must take action to protect MaineCare so it can remain available and accessible to seniors, children and those living with disabilities.”