An Act To Enhance Access to Affordable Health Care Transmitted to the Clerk of the 128th Maine Legislature by the Secretary of State on March 13, 2017 and ordered printed.
Maine Legislature, Session 128, LD 1039
Amends: 22 MRSA §3174-G

Legislative Document
No. 1039
I.B. 2
House of Representatives, March 14, 2017
An Act To Enhance Access to Affordable Health Care
Transmitted to the Clerk of the 128th Maine Legislature by the Secretary of State on March 
13, 2017 and ordered printed.
ROBERT B. HUNT
Clerk
Be it enacted by the People of the State of Maine as follows: 
PART A 
Sec. A-1.  22 MRSA §3174-G, sub-§1, ¶F, as amended by PL 2011, c. 380, Pt. 
KK, §2, is further amended to read: 
F.  A person 20 to 64 years of age who is not otherwise covered under paragraphs A 
to E when the person's family income is below or equal to 125% of the nonfarm 
income official poverty line, provided that as long as the commissioner shall adjust 
adjusts the maximum eligibility level in accordance with the requirements of the 
paragraph. 
 (2)  If the commissioner reasonably anticipates the cost of the program to exceed 
the budget of the population described in this paragraph, the commissioner shall 
lower the maximum eligibility level to the extent necessary to provide coverage 
to as many persons as possible within the program budget. 
 (3)  The commissioner shall give at least 30 days' notice of the proposed change 
in maximum eligibility level to the joint standing committee of the Legislature 
having jurisdiction over appropriations and financial affairs and the joint standing 
committee of the Legislature having jurisdiction over health and human services 
matters; and 
Sec. A-2.  22 MRSA §3174-G, sub-§1, ¶G, as enacted by PL 2011, c. 380, Pt. 
KK, §3, is amended to read: 
G.  A person who is a noncitizen legally admitted to the United States to the extent 
that coverage is allowable by federal law if the person is: 
(1)  A woman during her pregnancy and up to 60 days following delivery; or 
(2)  A child under 21 years of age.; and 
Sec. A-3.  22 MRSA §3174-G, sub-§1, ¶H is enacted to read: 
H.  No later than 180 days after the effective date of this paragraph, a person under 65 
years of age who is not otherwise eligible for assistance under this chapter and who 
qualifies for medical assistance pursuant to 42 United States Code, Section 
1396a(a)(10)(A)(i)(VIII) when the person's income is at or below 133% plus 5% of 
the nonfarm income official poverty line for the applicable family size. The 
department shall provide such a person, at a minimum, the same scope of medical 
assistance as is provided to a person described in paragraph E. 
Cost sharing, including copayments, for coverage established under this paragraph 
may not exceed the maximum allowable amounts authorized under section 3173-C, 
subsection 7. 
No later than 90 days after the effective date of this paragraph, the department shall 
submit a state plan amendment to the United States Department of Health and Human 
Services, Centers for Medicare and Medicaid Services ensuring MaineCare eligibility 
for people under 65 years of age who qualify for medical assistance pursuant to 42 
United States Code, Section 1396a(a)(10)(A)(i)(VIII). 
The department shall adopt rules, including emergency rules pursuant to Title 5, 
section 8054 if necessary, to implement this paragraph in a timely manner to ensure 
that the persons described in this paragraph are enrolled for and eligible to receive 
services no later than 180 days after the effective date of this paragraph.  Rules 
adopted pursuant to this paragraph are routine technical rules as defined by Title 5, 
chapter 375, subchapter 2-A. 
Sec. A-4.  Interim reporting.  Between the effective date of the Maine Revised 
Statutes, Title 22, section 3174-G, subsection 1, paragraph H and the dates of approval of 
the state plan amendment by the United States Department of Health and Human 
Services, Centers for Medicare and Medicaid Services necessary for implementation of 
Title 22, section 3174-G, subsection 1, paragraph H, the Department of Health and 
Human Services shall provide monthly reports to the joint standing committee of the 
Legislature having jurisdiction over health and human services matters and to the joint 
standing committee of the Legislature having jurisdiction over appropriations and 
financial affairs on the progress of implementation of that paragraph, any issues that 
might delay implementation or act as barriers to implementation and any possible 
solutions to those issues and barriers. 
Sec. A-5.  Reporting on implementation status.  No later than one year after 
the effective date of the Maine Revised Statutes, Title 22, section 3174-G, subsection 1, 
paragraph H, the Commissioner of Health and Human Services shall report to the joint 
standing committee of the Legislature having jurisdiction over health and human services 
matters and to the joint standing committee of the Legislature having jurisdiction over 
appropriations and financial affairs on the status of implementation of Title 22, section 
3174-G, subsection 1, paragraph H, including information on enrollment, costs, revenues 
generated from the Federal Government and other revenues, anticipated state savings and 
other issues pertinent to implementation. 
PART B 
Sec. B-1.  Calculation and transfer of savings.  The Commissioner of Health 
and Human Services, the Commissioner of Corrections and any state agency that 
recognizes savings as a result of implementation of the Maine Revised Statutes, Title 22, 
section 3174-G, subsection 1, paragraph H shall report within 60 days prior to the end of 
the first 12 months of enrollment under the Maine Revised Statutes, Title 22, section 
3174-G, subsection 1, paragraph H to the joint standing committee of the Legislature 
having jurisdiction over health and human services matters, the joint standing committee 
of the Legislature having jurisdiction over appropriations and financial affairs and the 
joint standing committee of the Legislature having jurisdiction over criminal justice and 
public safety matters on the amount of General Fund savings and other savings resulting 
from coverage provided under that paragraph, including but not limited to savings to 
substance abuse and mental health programs; medical services provided to persons in the 
care and custody of, or upon release by, the Department of Corrections or a county jail or 
regional jail; reimbursement to cities and towns for general assistance provided under 
Title 22, chapter 1161; services provided for individuals 21 years of age or older and 
under 64 years of age who are currently eligible for the MaineCare program under 
medically needy, spend-down criteria; services provided under the MaineCare program, 
Section 1115 Health Care Reform Demonstration for Individuals with HIV/AIDS; 
services provided for parents participating in family reunification activities under Title 
22, chapter 1071; an estimate of savings for services provided to individuals who 
previously would have pursued a disability determination to qualify for coverage; 
services provided to individuals awaiting a MaineCare program disability determination 
for whom the applications are subsequently granted; services provided under the State's 
breast and cervical cancer treatment program; and other programs in which savings are 
achieved.  The report must include the amount of savings realized during the preceding 
fiscal year by service area or program and the amount of savings projected to be achieved 
during the remainder of that fiscal year and during the next fiscal year by service area or 
program. 
Sec. B-2.  Reporting of revenue.  The Department of Administrative and 
Financial Services, Maine Revenue Services shall report to the joint standing committee 
of the Legislature having jurisdiction over appropriations and financial affairs no later 
than 60 days following the end of the first 12 months of enrollment under the Maine 
Revised Statutes, Title 22, section 3174-G, subsection 1, paragraph H regarding any new 
revenues, including any increase in federal medical assistance payments resulting from 
coverage provided under Title 22, section 3174-G, subsection 1, paragraph H.  Prior to 
the end of state fiscal year 2018-19, the State Controller shall transfer any savings 
amounts identified under this section to the MaineCare Stabilization Fund established 
under Title 22, section 3174-KK. 
Sec. B-3.  Evaluation by legislative office.  Within 90 days after the end of the 
first 12 months of enrollment under the Maine Revised Statutes, Title 22, section 3174-G, 
subsection 1, paragraph H, the Office of Fiscal and Program Review shall independently 
review reports required pursuant to sections 1 and 2 of this Part and report to the joint 
standing committee of the Legislature having jurisdiction over appropriations and 
financial affairs and the joint standing committee of the Legislature having jurisdiction 
over health and human services matters on its determination of the savings and new 
revenue, if any, resulting from implementation of Title 22, section 3174-G, subsection 1, 
paragraph H.  This report must also include information about the amount of federal 
funds received by the State as a result of coverage authorized under that paragraph. 
SUMMARY 
This initiated bill requires the State to provide federally approved Medicaid services 
through MaineCare to qualifying persons under 65 years of age with income equal to or 
below 133% plus 5% of the nonfarm income official poverty line. 
The initiated bill requires the Department of Health and Human Services to prepare 
and submit to the Federal Government any state plan amendments, no later than 90 days 
after the effective date of the initiated bill, necessary to implement the provisions of the 
initiated bill.  The initiated bill requires monthly reporting by the department to the 
appropriate joint standing committees of the Legislature on the status of a state plan 
amendment submission until such an amendment is approved and reporting on the status 
of implementation of the expanded coverage under MaineCare and on the status of 
implementation and savings generated to state-funded programs as a result of the 
expanded coverage.  It requires the Department of Administrative and Financial Services, 
Maine Revenue Services to report on revenues generated as a result of expanded 
coverage.  It requires any savings to be transferred to the MaineCare Stabilization Fund 
prior to the end of fiscal year 2018-19.  It requires the Office of Fiscal and Program 
Review to independently review these reports and report its findings to the appropriate 
joint standing committees of the Legislature.