An Act To Strengthen Maine's Hospitals, Increase Access to Health Care and Provide for a New Spirits Contract
Maine Legislature, Session 126, LD 1546
House Amendment HA_B_H196 (House)

HOUSE AMENDMENT £" to S.P. 589, L.D. 1546, Bill, "An Act To Strengthen 
Maine's Hospitals, Increase Access to Health Care and Provide for a New Spirits 
Contract" 
Amend the bill by striking out the title and substituting the following: 
'An Act To Enhance Revenues to the State from the Sale of Spirits, To Provide a 
Source of Payment for Maine's Hospitals and To Study the Issue of Medicaid 
Expansion' 
Amend the bill by striking out all of Parts C, D, E and F. 
Amend the bill by inserting after Part G the following: 
'PARTH 
Sec. H-l. Study group established. The Study Group To Examine the Issue of 
Medicaid Expansion, referred to in this Part as "the study group," is established. 
1. Membership. The study group consists of 13 members appointed as follows: 
A. Five members of the Senate appointed by the President of the Senate, including at 
least 2 members from the party holding the 2nd largest number of seats in the 
Legislature; 
B. Five members of the House of Representatives appointed by the Speaker of the 
House, including at least 2 members from the party holding the 2nd largest number of 
seats in the Legislature; 
C. One member representing the health care industry, appointed by the President of 
the Senate; 
D. One member appointed by the Governor; and 
E. The Commissioner of Health and Human Services or the commissioner's designee. 
2. Chairs. The first-named Senate member is the Senate chair and the first-named 
House of Representatives member is the House chair of the study group. 
HOUSE AMENDMENT 
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HOUSE AMENDMENT J3 .. to S.P. 589, L.D. 1546 
3. Appointments; convening of study group. All appointments must be made no 
later than 30 days following the effective date of this Part. The appointing authorities 
shall notify the Executive Director of the Legislative Council once all appointments have 
been completed. When the appointment of all members has been completed, the chairs 
shall call and convene the first meeting of the study group. If 30 days or more after the 
effective date of this Part a majority of but not all appointments have been made, the 
chairs may request authority and the Legislative Council may grant authority for the 
study group to meet and conduct its business. 
4. 
Duties. 
The study group shall study the issues associated with expanding 
Medicaid eligibility pursuant to the federal Patient Protection and Affordable Care Act. 
In conducting its review, the study group shall specifically examine: 
A. The projected costs to the State associated with an expansion of Medicaid 
eligibility during the 10 years immediately following such an expansion; 
B. The potential costs to the State associated with an expansion of Medicaid 
eligibility during the period following the time period described in paragraph A; 
C. Limitations on the growth of MaineCare that may be implemented to ensure that 
the State's other budget priorities receive adequate funding; 
D. The results of the expansion of Medicaid eligibility that occurred in the State in 
2002 and whether and how those results might inform the current question of 
expanding Medicaid eligibility; 
E. The existence of less costly alternatives to expanding Medicaid eligibility that 
might result in a reduction in the number of uninsured individuals in the State, such 
as utilization of the health insurance exchange to be established under the federal 
Patient Protection and Affordable Care Act; 
F. The possibility of obtaining from the Federal Government higher Medicaid 
matching rates or other benefits to citizens of the State as a result of the expansion of 
Medicaid as proposed in Legislative Document 1066; and 
G. Any other issues the study group determines appropriate. 
S. 
Staff assistance. 
The Legislative Council shall provide necessary staffing 
services to the study group. 
6. Report. No later than December 4,2013, the study group shall submit a report to 
the Legislative Council that includes its findings and recommendations, including any 
suggested legislation. ' 
Amend the bill by relettering or renumbering any nonconsecutive Part letter or 
section number to read consecutively. 
SUMMARY 
This amendment removes those parts of the bill related to MaineCare expansion. 
HOUSE AMENDMENT 
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HOUSE AMENDMENT:£ "to S.P. 589, L.D. 1546 
This amendment also establishes the Study Group To Examine the Issue of Medicaid 
Expansion to study the issues associated with expanding Medicaid eligibility pursuant to 
the federal Patient Protection and ~dable Care Act. 
NOTE REQUIRED 
SPONSORED BY: P,t/ 
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(Representative F 
TOWN: Newport 
HOUSE AMENDMENT 
Approved: 05117/13 
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LD 1546 
LR 2143(04) 
An Act To Strengthen Maine's Hospitals, Increase Access to Health Care and Provide for a New Spirits 
Contract 
Fiscal Note for House Amendment~' to Original Bill (H-lq~ 
Sponsor: Rep. Fredette of Newport 
Net Cost (Savings) 
General Fund 
Appropriations/Allocations 
General Fund 
Federal Expenditures Fund 
Other Special Revenue Funds 
Revenue 
Other Special Revenue Funds 
Legislative Cost/Study 
Fiscal Note Required: Yes 
Fiscal Note 
Legislative Cost/Study 
Projections FY Projections FY 
FY 2013-14 
FY 2014-15 
2015-16 
2016-17 
$689,851 
$689,851 
($92,152,589) 
($4,507,607) 
($4,507,607) 
$3,835,565 
$3,835,565 
($325,198,201) 
($4,635,029) 
($4,635,029) 
$3,778,658 
$3,778,658 
($341,132,913) 
($4,764,278) 
($4,764,278) 
($5,226,166) 
($5,226,1( 
($348,902,215) 
($4,897,404) 
($4,897,404) 
This amendment adds a study group to examine the issue of Medicaid expansion. The general operating expenses of 
this study group are projected to be $8,000 in fiscal year 2013-14. The Legislature's proposed budget includes $10,000 
in fiscal year 2013-14 and $10,000 in fiscal year 2014-15 for legislative studies. Whether the amounts are sufficient to 
fund all studies will depend on the number of studies authorized by the Legislative Council and the Legislature. The 
Legislature can absorb the additional costs of providing staff services to the study group within exisiting budgeted 
resources. 
Fiscal Detail and Notes 
This amendment eliminates Parts C, D, E and F from the bill that were related to the MaineCare expansion, which 
eliminates the net General Fund de appropriations in those Parts of$689,851 in fiscal year 2013-14 and $3,835,565 in 
fiscal year 2014-15. The elimination of those parts would also reduce allocations for both the Federal Expenditures 
Fund and Other Special Revenue Funds by eliminating those allocations from the bill. The reduction of Federal 
Expenditures Fund allocations total $92,152,589 in fiscal year 2013-14 and $325,198,201 in fiscal year 2014-15. The 
reduction of Other Special Revenue Funds allocations total $4,507,607 in fiscal year 2013-14 and $4,635,029 in fiscal 
year 2014-15. 
The Department of Health and Human Services can absorb the additional costs of the Commissioner of Health and 
Human Services' involvement as a member of the study group. 
LR2143(04) - Fiscal Note - Page 1 of 1