An Act to Make Supplemental Appropriations and Allocations from the General
Maine Legislature, Session 132, LD 0209
Committee Amendment CA_A_SA_D_S4 (Senate)
Amends: 22 MRSA §3197

FmST REGULAR SESSION
SENATE AMENDMENT " D " to COMMITTEE AMENDMENT "A" to H.P, 131,
L.D. 209, "An Act to Make Supplemental Appropriations and Allocations from the General
Fund and Other Funds for the Expenditures of State Government and to Change Certain
Provisions of the Law Necessary to the Proper Operations of State Government for the
Fiscal Year Ending June 30,2025"
Amend the amendment by insertuig after Part X the following:
'PART Y
Sec.Y-1. 22 MRSA §3197 is enacted to read;
S3197. Able-bodied, childless adults; temporary enrollment freeze? permanent
enrollment cap
Notwithstanding any provision of law to the contrary, the followine provisions apDJv
to Medicaid enrollment levels for enrollees who are classified as able-bodied. childless
adults.
1. Temporary enrollment freeze. Contingent on approval of a Section 1115
demonstration waiver under the United States Social Security Act from the United States
Department of Health and Human Services. Centers for Medicare and Medicaid Services.
within 30 days of the effective date of this section, the total number ofMaineCare enrollees
classified as able-bodied. childless adults that may be enrolled in the MaineCare oroeram
must be frozen and the enrollment level may not be increased. New enrollments of able-
bodied, childless adults may not be made until the department has certified that the total
lenrollment in this cateeory has been reduced by 10% from the level of enrollment at the
date enrollment is frozen under this subsection,
2. Enrollment reduction. When an enrollee becomes ineligible for MaineCare
coveraee. that enrollee may not be automatically reenrolled. When an enrollee's elieibilitv
lapses due to income increase, employment or failure to renew enrollment, that enrollee's
spot in the prosram may not be filled by a new enrollee. The department shall prioritize
proeram inteeritv measures to remove ineligible enrollees.
3. Lifting enrollment freeze; permanent enrollment cap. When the total enrollment
ofable-bodied. childless adults has declined by 10% from the number of enrollments at the
time of the enrollment freeze pursuant to subsection 1. the reduced level of enrollment is
SENATE AMENDMENT
SENATE AMENDMENT "J) " to COMMITTEE AMENDMENT "A" to H,P. 131, L.D. 209 (S' ^
established as a new permanent cap on the level of enrollment for able-bodied. childless
adults. The enrollment cap established pursuant to this section may not be exceeded unless
the Legislature specifically authonzes it,
4JLee|slative oversiehh quarterly proeress reports; additional proeram iuteedty
measures. Beeinnine 3 months after the effective date of this section. the department shall
submit quarterly reports to the Legislature detailine the department's efforts to reduce the
enrollment levels of able-bodjed, childless adults under^ybs^^^^^ the Legislature
determines that the department has failed to make meaningful progress, the Legislature
may impose additional program inteeritv measures to ensure compliance.
Sec. Y-2. MaineCare enrollment freeze; Department of Health and Human
Services to request waiver. No later than April 1,2025, the Department of Health and
Human Sefvicos shall request federal approval from the United States Department of
Health and Human Services, Centers for Medicare and Medicaid Services for a Section
1115 demonstration waiver under the United States Social Security Act that would
temporarily freeze MaineCare enrollment for able-bodied, childless adults, reduce
enrollment in that category over time and create a permanent enrollment cap at the reduced
enrollment level after the freeze is lifted. If the waiver is approved, the department shall
adopt rules to implement the enrollment freeze no later than 90 days after approval. Rules
adopted pursuant to this section are routine technical rules as defined in the Maine Revised
Statutes, Title 5, chapter 375, subchapter 2-A,
Sec. Y-3. Contingent effective date. That section of this Part that enacts the Maine
Revised Statutes, Title 22, section 3197 does not take effect unless approval of a Section
1115 demonstration waiver pursuant to section 2 of this Part is received, but no earlier than
July 1,2025.
The Commissioner of Health and Human Services shall notify the Secretary of State, the
Secretaiy of the Senate, the Clerk of the House and the Revisor of Statutes when approval
sought under section 2 of this Part is received.'
Amend the amendment by relettering or renumbering any nonconsecutive Part letter or
section number to read consecutively.
SUMMARY
This amendment requires the Department of Health and Human Services to request a
demonstration waiver from the United States Department of Health and Human Services,
Centers for Medicare and Medicaid Services to place a freeze on the level ofMaineCare
enrollment by enrollees who are able-bodied, childless adults. If the waiver is approved,
the amendment would require a freeze on enrollment for this classification ofem'ollees
within 30 days of the effective date of the amendment and require the department to
gradually reduce enrollment by 10%, When enrollment has been reduced by 10%, the level
of enrollment at that time becomes the new permanent cap on enrollment for that
classification of enrollees and the freeze is lifted. The department must submit to the
Legislature quarterly reports of its progress in reducing enrollment. If the department's
Page2-132LR2408(23)
SENATE AMENDMENT
i0^
SENATE AMENDMENT <<r[) " to COMMITTEE AMENDMENT "A" to H,P. 131, L.D. 209 (&^
progress is not satisfactory, the Leg^riature^may unpose additional program integrity
measures to ensure compliance,
SPONSORED BY:
(Senator STEWART, T.)
COUNTY: Aroostook
NOTEREQI
ieeat
miklumduKNt
SENATE AMENDMENT
Approved; 02/10/25 I^KI^
LD 209 LR 2408(23)
An Act to Make Supplemental Appropriations and Allocations from the General Fund and Other
Funds for the Expenditures of State Government and to Change Certain Provisions of the Law
Necessary to the Proper Operations of State Government for the Fiscal Year Ending June 30, 2025
Fiscal Note for Senate Amendment 1!^' to Committee Amendment "A" (S^{
Sponsor; Sen. Stewart ofAroostook
Fiscal Note Required: Yes
Fiscal Note
Contingent current biennium savings - General Fund
Fiscal Detail and Notes
The amendment requires the Department of Health and Human Services to, no later than April 1, 2025, request
federal approval from the United States Department of Health and Human Services, Centers for Medicare and
Medicaid Services for a Section 1115 demonstration waiver that would freeze Mainecare enrollment and create an
enrollment cap. If this waiver is approved, there would be savings in the Mainecare program, as some newly eligible
individuals would not be added to the program and members who become ineligible would be removed from the
program. The amount and timing of these contingent savings are not yet determined.
LR2408(23) - Fiscal Note - Page 1 of 1