Governor Signs First Supplemental DHHS Budget

Summary of the Compromise Budget
and What Comes Next

On February 23, 2012 the Governor signed legislation to close a $121 million gap in the budget for state Fiscal Year 2012.(This legislation also included $25 million in cuts from a separate bill that legislators have been working on since last fall. Most of these cuts are administrative and will not be discussed in this summary.)

In order to reach this deal, compromises were made. Some of these compromises will cut programs and services that serve working families, the poor and people with disabilities. These cuts are going to be painful and were strongly opposed by MEJP, MAIN and many other allies.

Unfortunately, the Governor presented lawmakers with a nearly impossible task. Legislators on the Appropriations Committee who did not want to cut health care fought hard to prevent those cuts. In the end, they were forced to agree with some cuts in order to prevent even greater harm. Certain MaineCare members who are affected by these changes will need to take steps to protect their coverage.

This is important information for childless adults and certain parents currently enrolled in MaineCare.

• Any MaineCare recipient currently on the Childless Adult Program must be sure to complete and send in their annual recertification form.
  The program was cut in the budget (see details below), but people who are on the program will stay on. This means that if you are on the program now, it is extremely important that you fill out and return your review form to recertify for the program. If you do not recertify for the program, you WILL lose coverage and you will be unable to get your MaineCare coverage back. If your address has changed or if you change your address, give your new address to DHHS as quickly as possible.



• Parents with income between 133% and 150% of the Federal Poverty Level should recertify their eligibility if their annual review comes up before October 1, 2012.
  The budget eliminates coverage for parents with income between 133% FPL and 200% FPL. However, parents with income between 133% FPL ($2,116 per month for family of 3) and 150% FPL ($2387 per month for a family of 3) may be eligible for transitional MaineCare if they are working or receiving child support. Transitional MaineCare will be for 3, 6 or 12 months depending upon a family’s circumstance. Parents will only be eligible for transitional MaineCare if they are enrolled in the program when DHHS sends out termination notices. Coverage for MaineCare will be terminated on October 1, 2012. This means that if a parent’s annual review is between now and October 1 and the parent fails to complete the paperwork to renew, he/she will not be eligible for additional months of MaineCare coverage.

Here is a summary of some of the cuts included in the legislation:

Enrollment in the Childless Adult waiver program will be frozen. Spending in the program will move from an annual budget cap of $80.3 million to $40 million. The compromise protects coverage for the approximately 17,000 individuals currently on the program but prevents the 16,000 individuals on the waitlist from getting on MaineCare at least through June, 2013. Some further cuts may be made next year if this budget target is not reached.

Low-income working parents with incomes above 133% of poverty ($2,116/month for a family of 3) will lose their coverage. Approximately 14,000 parents will lose MaineCare coverage as of October 1, 2012. Some of these parents may be eligible for some months of “transitional” MaineCare benefits.

Some MaineCare services were cut. These cuts are likely to go into effect this spring:

• Vision services: routine eye exams will now be available once every 3 years instead of every 2 years as currently allowed;


• Chiropractic services: limited to 12 visits per year;


• Smoking cessation services: 50% of funding for Smoking Cessation services has been cut. This will likely mean that some products that help people quit will not be available;


• Methadone Treatment/clinics: the bundled weekly treatment rate was reduced from $70 to $60 per week;


• Targeted Case Management: MaineHousing will provide the money to MaineCare for one year to pay for Targeted Case Management for people who are homeless. This is expected to lead to a cut of $300,000 to programs funded through the MaineHousing HOME fund;


• Reimbursement rates: 10% provider rate reduction for the following services:
• Occupational and physical therapy
• Podiatry
• Adult family Care;


• Brand Name Prescriptions: Limit to only 2 brand-name prescription drugs per month. Additional brand name drugs may be available if your medical provider says that they are medically necessary for you (the current limit is 4 per month);


• Hospital Services: Limit to 5 inpatient hospital stays per year; and


• Limits on certain pain medications: 45-day limit on certain pain medications (opioids), unless prescribed to treat cancer, HIV or AIDS, or if the a person is in the hospital or receiving Hospice care. For people who have been treated for pain with one of these medications for a year or more, this cut will not go into effect until September 1, 2012. For all others it will likely go into effect sometime this spring. (This limit may not be allowed under federal law. Look for additional information in future mailings).

These cuts are hard to swallow. The legislation will deny health care coverage to thousands of people and limit important services. At the same time, it protects thousands of people who would have lost coverage and even more services under the Governor's irresponsible proposal.

The fight to protect health care and to win a fair and just budget continues. The compromise brings the current 2012 fiscal year budget into balance, but work remains to be done to close a budget gap for fiscal year 2013.

In this work, legislators will address other proposals in the Governor’s budget, including the proposed cut to the Medicare Savings Program (MSP), which helps seniors and people with disabilities pay for drugs and healthcare costs. The 2013 budget will also address the Governor’s proposed cut to eliminate MaineCare coverage for 19 and 20 year olds who are under 150% of the poverty level. Many programs supported by the Fund for a Healthy Maine, including funding for Head Start and child care subsidies, will also be at risk.

We will keep you updated as this moves through the legislature and when it is most helpful to weigh in with your legislators.

March 2012