Appeals court affirms that Maine's Medicaid program must cover low-income 19- and 20-year-olds

Gov. Paul LePage's administration cannot remove thousands of low-income young people from Maine's Medicaid rolls, a federal appeals court judge ruled Monday.

Chief Judge Sandra Lynch of the 1st Circuit Court of Appeals in Boston ruled that the federal government was correct in rejecting the Republican governor's plan to eliminate coverage for about 6,000 19- and 20-year-olds.

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The ruling drew swift criticism from Maine Department of Health and Human Services Commissioner Mary Mayhew, who said the state's "welfare funds should be prioritized toward the elderly, disabled and truly needy; not the job-ready young adults."

"By moving the goalposts and forcing Maine taxpayers to pay for more welfare, the federal government is using its heavy hand to push its agenda of putting as many people as possible on a broken Medicaid system," she said. "Washington has the luxury of paying for its programs with deficits and debt; in Maine, we must set priorities and balance our budget."

The proposed cuts were part of a larger Medicaid overhaul LePage sought in 2012, saying the state offers more extensive benefits than others do and that the program's ballooning costs were devastating Maine's budget.

The administration argued that the cuts were legal because the Supreme Court decision that upheld President Barack Obama's federal health care overhaul limited congressional power to expand Medicaid, and it appealed the decision after the federal government rejected the proposal last year.

Lynch agreed with the U.S. Department of Health and Human Services that rolling back coverage for low-income 19- and 20-year-olds in Maine is illegal because the Affordable Care Act requires states to maintain their coverage levels for children until 2019. Maine has covered that population for more than 20 years, the judge said.

Coverage for this group is critical because young adults have high rates of mental health and substance abuse problems that would go unattended if they don't have health coverage, said Jack Comart, litigation director with Maine Equal Justice Partners, which opposed the state's proposal.

The proposal would have eliminated coverage for a young adult who lives alone and makes less than about $1,500 a month or lives with their parents and makes less than about $2,600 a month, he said.

"They are at an important point in their lives where they are transitioning into adulthood and it's important that they have a healthy start to that," Comart said. "It's the point where either they succeed or maybe go down a bad path."

Mayhew said the state is reviewing its options for what to do next but pledged to continue "fighting for the flexibility states need from the federal government to manage their welfare programs, balance their budgets, and ensure that the needs of taxpayers and the truly needy are not forgotten."


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