An Act To Protect the MaineCare Program
Maine Legislature, Session 122, LD 0318
Committee: Health and Human Services
Sponsors: McKANE, DOW, BISHOP, HOGAN, LINDELL, PILON, SHIELDS, VAUGHAN, SNOWE-MELLO
Amends: 22 MRSA §3174-G, 22 MRSA §3174-F

Legislative Document 
No. 318 
H.P.242 
House of Representatives, January 19,2005 
An Act To Protect the MaineCare Program 
Reference to the Committee on Health and Human Services suggested and ordered printed. 
Presented by Representative McKANE of Newcastle. 
Cosponsored by Senator DOW of Lincoln and 
'17/~ /h. 7!/0£~ 
MILLICENT M. MacFARLAND 
Clerk 
Representatives: BISHOP of Boothbay, HOGAN of Old Orchard Beach, LINDELL of 
Frankfort, PILON of Saco, SHIELDS of Auburn, VAUGHAN of Durham, Senator: SNOWE-
MELLO of Androscoggin. 
Printed on recycled paper 
Be it enacted by the People of the State of Maine as follows: 
Sec. I. 22 MRS A §3174-G, sub-§I, ,D, as amended by PL 2003, c. 
673, Pt. Y, §2, is further amended to read: 
D. 
A child one year of age or older and under 19 years of 
age when the child's family income is equal to or below 150% 
of the nonfarm income official poverty line, except that the 
department may 
adopt 
a 
rule that provides that children 
described in this paragraph in families with income over 
150% 
and equal to or below 
200% 
of the 
nonfarm 
income 
official poverty line who meet the eligibility requirements 
of the Cub Care program established under section 3l74-T are 
eligible to participate in the Cub Care program instead of 
Medicaid. 
Rules 
adopted pursuant to this paragraph are 
routine technical rules as defined in Title 5, chapter 375, 
subchapter 2-A; and 
Sec. 2. 22 MRSA §3174-G, sub-§I, ,E, as amended by PL 2001, c. 
450, Pt. A, §1, is further amended to read: 
E. 
The parent or caretaker relative of a child described in 
paragraph B or D when the child's family income is equal to 
or below 150°", of the nonfarm income official poverty line, 
subject 
to 
adjustment 
by 
the 
commissioner 
under 
this 
paragraph. 
Medicaid services provided under this paragraph 
must be provided wi thin the limits of the program budget. 
Funds appropriated for services under this paragraph must 
include an annual inflationary adjustment equivalent to the 
rate of inflation in the Medicaid program. 
On a quarterly 
basis, the commissioner shall determine the fiscal status of 
program 
expenditures 
under 
this 
paragraph. 
If 
the 
commissioner determines that expenditures will exceed the 
funds available to provide Medicaid coverage pursuant to 
this 
paragraph, 
the 
commissioner 
m~s~ shall 
adjust 
the 
income eligibility limit for new applicants to the extent 
necessary to operate the program wi thin the program budget. 
If, 
after 
an 
adjustment 
has 
occurred 
pursuant 
to 
this 
paragraph, expenditures fall below the program budget, the 
commissioner 
m~s~ shall raise the income eligibility limit 
to the extent necessary to provide services to as 
many 
eligible persons as possible within the fiscal constraints 
of the program budget, as long as the income limit does not 
exceed 150% of the nonfarm income official poverty linef-ana~ 
Sec. 3. 22 MRSA §3174-G. sub-§1.1[F, as enacted by PL 2001, c. 
450, Pt. A, §2, is repealed. 
Sec. 4. 22 MRSA §3174-FF, sub-§3, 1JH, as enacted by PL 2003, 
c. 673, Pt. MMM, §l, is repealed. 
Page l-LR0520(1) 
Sec. 5. PL 2003. c. 469. Pt. A. §5 is repealed. 
Sec. 6. 
Rulemaking. 
By 
July 
1, 
2005, 
the Department 
of 
Health and 
Human Services shall adopt rules 
to increase the 
reimbursement rate for hospitals under the MaineCare program from 
75% 
to 
88% 
of actual costs. 
Rules 
adopted pursuant to this 
section are routine technical rules 
as defined in the Maine 
Revised Statutes, Title 5, chapter 375, subchapter 2-A. 
SUMMARY 
This bill amends the MaineCare law as follows: 
1. 
It returns 
the 
MaineCare eligibility levels 
to 
the 
levels in effect prior to the passage of the Dirigo Health law, 
Public Law 2003, chapter 469: 
2. 
It 
eliminates 
the 
noncategorical 
adult 
eligibility 
expansion of the MaineCare program: 
3. 
It 
increases 
hospitals from 75°" to 
Medicare: and 
the 
MaineCare 
reimbursement 
rate 
for 
88°0 of their actual costs, the same as 
4. 
It repeals that provision of the MaineCare Basic program 
in 
the 
Maine 
Revised 
Statutes, 
Title 
22, 
section 
3174-FF, 
subsection 3, paragraph H that relates to MaineCare coverage for 
noncategorical adults.