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Supreme Court Ruling Doesn’t Let Maine (or Other States) Cut Thousands from Medicaid

Under the health reform law, states must keep their current Medicaid eligibility rules for adults until 2014, when new, nationwide Medicaid eligibility rules will take effect and state-based health insurance exchanges will begin operating.  States must also maintain their Medicaid and CHIP eligibility rules for children until 2019.  (These are known as maintenance of eligibility, or MOE, requirements.)

The Supreme Court’s recent ruling on health reform means that states cannot lose federal funding if they do not expand their Medicaid programs to cover adults with incomes below 133 percent of the poverty line who become newly eligible under the law.  The ruling did not, however, roll back the MOE rules or affect any other provisions of the law, as Health and Human Services Secretary Kathleen Sebelius explained last week in a letter to the nation’s governors.

The Congressional Research Service agreed with Secretary Sebelius’ position this week, stating in a memo that the Court’s decision “does not make changes to the current Medicaid program,” including the MOE requirements.

Maine Governor Paul LePage nevertheless claims that the Court’s decision means that Maine no longer must follow the law.  The state plans to seek permission from HHS to cut 15,000 parents and more than 6,000 19- and 20-year olds from its Medicaid program in an effort to close its budget gap.  Maine also wants to make changes that would affect low-income seniors and people with disabilities who get help paying for prescription drugs and other health care services.

Secretary Sebelius made clear, however, that the MOE is still in place.  HHS will almost certainly deny Maine’s request — and in the process, protect thousands of Maine’s low-income residents from losing access to valuable health care.