At a glance:
- Some lawmakers are blocking a budget they previously supported, delaying funds needed for hospitals and health care providers
- Many hospitals, especially in rural areas, are struggling financially and have very little money saved — these delays could make it even harder for them to stay open and care for patients
- Many people in Republican-led districts rely on Medicaid, yet some of their representatives are trying to stop the budget
Republican members of the Appropriations Committee are now opposing the supplemental budget they previously supported, threatening to block the two-thirds vote needed for it to take effect immediately. Without this approval, the supplemental budget could not take effect until May at the earliest — jeopardizing Medicaid (MaineCare) payments to health care providers.
The supplemental budget includes $118 million in additional MaineCare funding. Delays could push struggling hospitals and rural health care providers into deeper financial distress. As the Maine Hospital Association testified on the budget bill, “it would not be fair to hospitals and other providers to leave the state short of funds it will need a few months from now to pay for care being provided today.”
Many providers already have slim margins and limited reserves. MHA lobbyist Jeff Austin said, “In my fourteen years of representing hospitals in Maine, this is the scariest I’ve ever seen it from a financial perspective.” According to the Maine Health Data Organization the median Maine hospital only had 40 days’ cash on hand in 2022, with several hospitals having access to a week’s cushion or less.
Rural areas would be hit hardest, as Medicaid covers a large share of residents — 43% in Washington County, 40% in Somerset, 39% in Aroostook, and 38% in Piscataquis according to data from Maine’s Office of Family Independence. Several hospitals, including Penobscot Bay Medical Center in Rockland, Waldo County General Hospital in Belfast, St Mary’s Regional Medical Center in Lewiston, Calais Community Hospital and Lincoln Health in Boothbay, rely on Medicaid for at least 20% of their revenue based on estimates by the National Academy for State Health Policy.
Ironically, the delay would harm the very districts represented by Republicans leading the opposition. MECEP estimates 53% of MaineCare enrollees live in House Districts represented by Republicans. This includes nearly 22% of residents in Minority Leader Billy Bob Faulkingham’s district and one in four residents represented by Representative Ken Fredette, the appropriations committee member who is leading the charge to scuttle the deal agreed to previously by his Republican colleagues on the committee. In Senate Minority Leader Trey Stewart’s district, one in three residents depend on MaineCare, yet he has declared the supplemental budget “isn’t going to pass.”
Source: MECEP analysis of US Census Bureau, American Community Survey data, 2019-2023 five-year averages
Lawmakers must put politics aside and pass the bipartisan supplemental budget deal they agreed to last week. The deal does not address every health care need in Maine — for example, statutory cost-of-living payments to providers remain unpaid — but given the urgency of the moment, those can be addressed in the biennial budget once the supplemental is passed. The health of 400,000 Mainers and the stability of hospitals and medical practices statewide depend on it.
