An Act to Make Supplemental Appropriations and Allocations from the General
Maine Legislature, Session 132, LD 0209
Committee Amendment CA_A_HA_B_H3 (House)
Amends: 22 MRSA §3197

HOUSE AMENDMENT" 8 "to COMMITTEE AMENDMENT "N' 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 Ce1iain 
Provisions of the Law Necessary to the Proper Operations of State Government for the 
Fiscal Year Ending June 30, 20251' 
Amend the amendment by inserting after Part X the following: 
'PARTY 
Sec. Y-1. 22 MRSA §3197 is enacted to read: 
§3197. 
Able-bodied, childless adults; tempo1·ary enrollment freeze; permanent 
enrollment cap 
Notwithstanding any provision of law to the contrary. the following provisions apply 
to Medicaid enrollment levels for enrollees who are classified as able-bodied. childless 
adults. 
1. Temporary enrollmeut freeze. Contingent on appl'Oval 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 
2S 
classified as able-bodied, childless adults that may be emolled in the MaineCare pl'Ogl'am 
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 
enrollment u1 this catego1y has been reduced by 10% from the level of enrollment at the 
date enrollment is frozen undel' this subsection. 
2. Enrollment reduction. When an enrollee becomes ineligible for MaineCare 
coverage, that enrollee may not be automatically reenrolled. When an enrollee's eligibility 
lapses due to income increase. employment 01· failure to renew enrollment. that enrollee's 
spot in the program may not be filled by a new enrollee. The department shall pl'ioritize 
progrnm integrity measures to remove ineligible enrollees. 
3S 
3. Lifting enrollment freeze; permanent enrollment cap. When the total enrollment 
of able-bodied. childless adults has declined by I 0% from the numbe1· of enrollments at the 
time of the enrollment freeze pursuant to subsection 1. the reduced level of enrollment is 
HOUSE AMENDMENT 
~o'b 
), 
HOUSE AMENDMENT" i "to COMMITTEE AMENDMENT "A" to H.P. 131, L.D. 209 
established as a new permanent cap on the level of t,nrollment for able-bodied~ childless 
adults. The enl'ollment cap established pursuant to this section may not be exceeded unless 
the Legislature specifically authorizes it. 
4. Legislative oversight; guarterly pl'Ognss reports; additional program integrity 
measures, Beginning 3 months after the effective date of this section, the depa1tment shall 
submit quaiterly reports to the Legislature detailing the depa1tment's efforts to reduce the 
enrollment levels of able-bodied, childless adults under subsectio11 2. If the Legislature 
determines that the department has failed to make meaningful progress, the Legislature 
may impose additional program integrity 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 Services shall request federal approval from the United States Depa11ment 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 
temporal'ily freeze MaineCare enroUment for able-bodied, childless adults, reduce 
enrollment in that catego1y over time and create a permanent enrollment cap at the reduced 
emollment level after the freeze is lifted. If the waiver is approved, the department shall 
adopt rnles 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 Patt 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 I, 2025. 
The Commissioner of Health and Human Services shall notify the Secreta1y of State, the 
Secretary 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 ame11dment by relettering 01· renumbering any nonconsecutive Patt letter or 
section number to read consecutively. 
SUMMARY 
This amendment requires the Department of Health and Human Services to request a 
demonstration waivel' from the United States Depaitment of Health and Human Services, 
Centers for Medicare and Medicaid Services to place a freeze on the level of MaineCare 
emollment by enrollees who are able-bodied, childless adults. If the waiver is approved, 
the amendment would require a freeze on enrollment for this classification of enrollees 
within 30 days of the effective date of the amendment and require the depatiment to 
gradually reduce enrollment by I 0%. When emollment 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 repo1ts of its progress in 1·educing enrollment. If the department's 
HOUSE AMENDMENT 
HOUSE AMENDMENT" B "to COMMITTEE AMENDMENT"A" to H.P. 131, L,D, 209 
progress is not 
measul'es to e , ur 
FISCAL NOTE REQUIRED 
(See attached) 
HOUSE AMENDMENT 
Approved: 02/10/25 LRL 
LD209 
LR2408(14) 
Au 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 Y car Ending June 30, 2025 
Fiscal Note for House Amendment 'B" to Committee Amendment "A" l-\-3 
Sponsor: Rep. Ducharme of Madison 
Fiscal Note Required: Yes 
Fiscal Note 
Contingent cunent biennium savings - Gener&! Fund 
Fiscal Detail and Notes 
The amendment requires the Department of Health and Human Services to, no later than April l, 2025, request 
federal approval from the United States Depa1tment of Health and Human Services, Centers for Medicare and 
Medicaid Services for a Section 1115 demonstration waiver that would freeze Mainecare emoltment and create an 
enrollment cap. If this waiver is approved, there would be savings in the Mainecare prog1·am, as some newly eligible 
individuals would not be added to the program and members who become ineligible would be removed from the 
progmm. The amount and timing of these contingent savings are not yet determined. 
LR2408(14) - Fiscal Note - Page I of 1