An Act to Empower Patients and Eliminate Welfare Cliffs in the MaineCare Program by Establishing a MaineCare Savings Account Pilot Program
Maine Legislature, Session 131, LD 1269
Committee: Health and Human Services
Sponsors: BRAKEY, MOORE, BOYER, JAVNER, LEMELIN, MORRIS
Amends: 22 MRSA §3197

Legislative Document
No. 1269
S.P. 506
In Senate, March 21, 2023
An Act to Empower Patients and Eliminate Welfare Cliffs in the 
MaineCare Program by Establishing a MaineCare Savings Account 
Pilot Program
Reference to the Committee on Health and Human Services suggested and ordered printed.
DAREK M. GRANT
Secretary of the Senate
Presented by Senator BRAKEY of Androscoggin.
Cosponsored by Senator: MOORE of Washington, Representatives: BOYER of Poland, 
JAVNER of Chester, LEMELIN of Chelsea, MORRIS of Turner.
Be it enacted by the People of the State of Maine as follows:
Sec. 1.  22 MRSA §3197 is enacted to read:
§3197.  MaineCare savings accounts
The department shall apply to the United States Department of Health and Human 
Services, Centers for Medicare and Medicaid Services for a waiver of the requirements of 
Section 1902 of the United States Social Security Act to allow the department to establish 
a pilot program that would allow an individual eligible for the MaineCare program to 
choose, in lieu of standard MaineCare coverage, to receive Medicaid funds, commensurate 
with the individual's income and disability, and deposit the funds into a MaineCare savings 
account to be used to purchase commercial health insurance or to pay for health care 
services directly. The program must include the option to choose among a variety of 
commercial health insurance plans, including high deductible plans. The program must also 
include an option to allow individuals to use funds from the MaineCare savings account to 
purchase low-cost and routine care while retaining standard MaineCare coverage for 
higher-cost services.  The program must provide that any funds remaining at the end of a 
calendar year are rolled over into the subsequent year. If the department receives approval 
for the waiver, it shall establish the pilot program and adopt rules to implement this section. 
Rules adopted pursuant to this section are routine technical rules as defined by Title 5, 
chapter 375, subchapter 2‑A.
Sec. 2. Department of Health and Human Services waiver request. Within 
days of the effective date of this Act, the Department of Health and Human Services 
shall apply to the United States Department of Health and Human Services, Centers for 
Medicare and Medicaid Services for a waiver in accordance with the Maine Revised 
Statutes, Title 22, section 3197. The department shall report to the Joint Standing 
Committee on Health and Human Services by December 6, 2023 regarding the status of its 
application for a waiver.
SUMMARY
This bill requires the Department of Health and Human Services, within 90 days of the 
effective date of this legislation, to apply to the United States Department of Health and 
Human Services, Centers for Medicare and Medicaid Services for a waiver of the 
requirements of Section 1902 of the United States Social Security Act to allow the 
department to establish a pilot program that would allow an individual eligible for the 
MaineCare program to choose, in lieu of standard MaineCare coverage, to receive 
Medicaid funds, commensurate with the individual's income and disability, and deposit the 
funds into a MaineCare savings account to be used to purchase commercial health 
insurance or to pay for health care services directly. The program must include the option 
to choose among a variety of commercial health insurance plans, including high deductible 
plans. The program must also include an option to allow individuals to use funds from the 
MaineCare savings account to purchase low-cost and routine care while retaining standard 
MaineCare coverage for higher-cost services.  The program must provide that any funds 
remaining at the end of a calendar year are rolled over into the subsequent year. The bill 
requires that if the department receives approval for the waiver, it must establish the pilot 
program and adopt rules to implement the program. It requires the department to report to 
the Joint Standing Committee on Health and Human Services by December 6, 2023 
regarding the status of its application for a waiver.