Opinion ID: 4306719
Heading Depth: 1
Heading Rank: 4

Heading: maintaining the stay

Text: [¶30] Pending our reaching the merits of the Commissioner’s appeal, the conditions in June that led us to order a stay of the Superior Court’s mandate have not changed. If anything, the conditions today more strongly favor a stay because the plaintiffs have been quite honest in stating that they hope to fund the Medicaid benefits they seek by taking from funds already appropriated for current Medicaid beneficiaries and using those funds to pay benefits to the 70,000 newly eligible individuals. [¶31] Requests for stays or injunctions before the Law Court are subject to the same standards for obtaining injunctive relief that are applied in the trial courts. See Bangor Historic Track, Inc. v. Dep’t of Agric., Food & Rural Resources, 2003 ME 140, ¶¶ 9-12, 837 A.2d 129. To obtain a stay, the moving party “must 17 demonstrate that (1) it will suffer irreparable injury if the injunction is not granted; (2) such injury outweighs any harm which granting the injunctive relief would inflict on the other party; (3) it has a likelihood of success on the merits (at most, a probability; at least, a substantial possibility); and (4) the public interest will not be adversely affected by granting the injunction.” Id. ¶ 9 (citing Emerson, 563 A.2d at 768); accord Respect Me. PAC v. McKee, 622 F.3d 13, 15 (1st Cir. 2010) (noting that the “most critical” factors in considering a stay pending appeal are “(1) whether the applicant has made a strong showing that he is likely to succeed on the merits; [and] (2) whether the applicant will be irreparably injured absent relief. . . . Plaintiffs must show a strong likelihood of success, and they must demonstrate that irreparable injury will be likely absent an injunction.” (citing Winter v. Natural Res. Def. Council, Inc., 555 U.S. 7, 21-22 (2008))).
[¶32] Addressing irreparable injury first: The plaintiffs propose to fund the Medicaid expansion by taking funds already appropriated to support payments to those who qualified to receive Medicaid benefits before approval of the citizen initiative. The plaintiffs recognize that their plan will exhaust the fiscal year 2019 appropriation sometime next spring, well before the end of the 18 fiscal year. By then, the plaintiffs argue, the Legislature and the Governor may authorize new resources to assure that benefits can be paid to all through the end of the fiscal year. In the meantime, current Medicaid beneficiaries and health care providers will be irreparably injured by longer wait times for treatment, delays in claims processing and payments, and reduced availability of out-patient and in-patient care occasioned by a large influx of new patients competing to use already too limited staff, facilities, and financial resources. [¶33] The public and the taxpayers will also be harmed if shortfalls in Medicaid funding require tax increases or cuts in other programs or services to make up for the shortfall in Medicaid funding. Thus, there is a sufficient demonstration of irreparable injury to support maintaining the stay of the Superior Court’s mandate.
[¶34] Turning to the question of probable or strong likelihood of success on the merits: No matter how much the Commissioner may want to prepare and submit a Medicaid expansion plan to the federal government, federal law bars him from doing so without an identified source of funds to support the expanded program throughout the fiscal year, not just for the first nine or ten months of the fiscal year. 19 [¶35] The lengthy and detailed federal law that governs filing a state Medicaid plan is 42 U.S.C.S. § 1396a (LEXIS through Pub. L. No. 115-230). Section 1396a(a)(2) directs, “A State plan for medical assistance must . . . provide for financial participation by the State equal to not less than 40 per centum of the non-Federal share of the expenditures under the plan with respect to which payments under [42 U.S.C.S. § 1396b] are authorized by this title . . . and . . . provide for financial participation by the State equal to all of such non-Federal share or provide for distribution of funds from Federal or State sources, for carrying out the State plan, on an equalization or other basis which will assure that the lack of adequate funds from local sources will not result in lowering the amount, duration, scope, or quality of care and services available under the plan.” (Emphasis added.) [¶36] Later provisions in section 1396a establish that the relevant non-Federal share of required state participation in the Medicaid expansion program will be ten percent of program costs. There being no funds appropriated for Medicaid expansion, the Commissioner has no capacity to submit a plan identifying the required state financial participation, estimated to be more than $40,000,000 for fiscal year 2019, according to the record before this Court. 20 [¶37] The plaintiffs argue that there are sufficient resources to meet the plan’s financial requirements by utilizing the existing Medicaid appropriation to support the expanded eligibility, and that this resource is sufficient to carry the program into next spring. That argument ignores that second part of section 1396a(a)(2), which requires that the financial plan not only serve the present but “assure that the lack of adequate funds from local sources will not result in lowering the amount, duration, scope, or quality of care and services available under the plan.” 42 U.S.C.S. § 1396a. If the plaintiffs’ funding plan were adopted or included in a plan ordered submitted by the court, the approved Medicaid plan to serve current Medicaid beneficiaries could be placed at risk because, by design, the plaintiffs’ financial plan, by next spring, will “result in lowering the amount, duration, scope, or quality of care and services available under the plan.” Id. [¶38] The plaintiffs also argue that if no appropriation of $40,000,000 is forthcoming, the state courts, or perhaps the federal courts, could order that state funds be gathered from other sources and spent to serve the needs of those made eligible for services by the Medicaid expansion law. In effect, the plaintiffs invite the courts to become a last resort appropriations process, directing funding for programs and services authorized by law but not funded, 21 or not sufficiently funded, through the legislative and gubernatorial appropriations approval process. [¶39] Court involvement in ordering funding for statutorily authorized programs, when appropriations to support such programs fail or are viewed as inadequate to meet perceived needs, would violate Maine’s strict separation of powers requirements as stated in article III of the Maine Constitution (Distribution of Powers). Article III states: Section 1. Powers distributed. The powers of this government shall be divided into 3 distinct departments, the legislative, executive and judicial. Section 2. To be kept separate. No person or persons, belonging to one of these departments, shall exercise any of the powers properly belonging to either of the others, except in the cases herein expressly directed or permitted. [¶40] In Sawyer v. Gilmore, 109 Me. 169, 178, 83 A. 673 (1912), when called upon to review a legislatively approved school funding formula asserted to be an unconstitutional violation of equal protection, we declined, observing, “We are not to substitute our judgment for that of a coordinate branch of the government working within its constitutional limits.” Id. Later in the opinion, and relevant to the case at hand, we reminded litigants that it is not always borne in mind that the Constitution operates differently with respect to these different branches. The authority of the executive and judicial departments is a grant. These 22 departments can exercise only the powers enumerated in and conferred upon them by the Constitution and such as are necessarily implied therefrom. The powers of the Legislature in matters of legislation, broadly speaking are absolute, except as restricted and limited by the Constitution. As to the executive, and judiciary, the Constitution measures the extent of their authority, as to the Legislature it measures the limitations upon its authority. Id. at 180. [¶41] The limitations on the power of the courts to order State spending for statutorily authorized programs, for which appropriations have not been approved, or for which approved appropriations are deemed inadequate, are emphasized by Me. Const., art. V, pt. 3, § 4: Section 4. No money drawn except upon appropriation or allocation. No money shall be drawn from the treasury, except in consequence of appropriations or allocations authorized by law. [¶42] In Weston v. Dane, 51 Me. 461 (1862), and Weston v. Dane, 53 Me. 372 (1865), the Court considered a legislative resolve that had authorized George Weston to be paid a commission of twenty percent for his successful efforts to obtain federal reimbursement for state expenditures for a regiment organized and sent by the State in the Mexican War. The commission was to be paid from the recovered funds, which totaled $ 10,308.28. Weston, 51 Me. at 463. Weston brought an action for a writ of mandamus to recover $1,000 that remained unpaid. Id. 23 [¶43] Addressing an older version of Me. Const., art. V, pt. 3, § 4,6 the Court held that it could not order reimbursement of authorized funds without appropriation and, under the older version of section 4, a governor’s warrant. “The petition, stripped of the specious disguise thrown around it by the able argument of counsel in its support, asks us to command the treasurer to pay money in violation of the clear and distinct provisions of the constitution, by virtue of which he and we exercise the several trusts reposed alike in him and in us. The writ is denied.” Weston, 51 Me. at 465. The 1865 opinion addressed the same claim, but without specific reference to Me. Const., art. V, pt. 3, § 4. Weston, 53 Me. At 372-373. [¶44] Relevant, more modern opinions include KHK Associates v. Department of Human Services, 632 A.2d 138 at 140-141 (Me. 1993), which, as part of its reasoning, applied Me. Const., art. V, pt. 3, § 4, in allowing the State to abandon a lease for a building that had been built for the State in Aroostook County because of financial cutbacks and lack of an appropriation. See also SC Testing Technology, Inc. v. Department of Environmental Protection, 6 The older version of Me. Const., art. V, pt. 3, § 4 stated that no money shall be drawn from the treasury, but by warrant from the Governor and Council, and in consequence of appropriations made by law; and a regular statement and account of the receipts and expenditures of all public money shall be published at the commencement of the annual session of the Legislature. Weston v. Dane, 51 Me. 461, 463-64 (1862). In the citation, the Weston opinion references “part 4,” but this is a citation error. 24 688 A.2d 421 at 424-425 (Me. 1996), another case where the Court approved the State abandoning a contract after the contractor had made significant commitments pursuant to a legislative authorization that was not funded by an appropriation. [¶45] While not reaching the merits, the Court suggests that the citizen initiative portion of Me. Const., art. IV, pt. 3, § 19, may authorize the courts to mandate funding for citizen-initiated legislation that requires funding if the Legislature fails to appropriate funds to implement the initiative. Court’s Opinion ¶ 10. Section 19 provides, in pertinent part, “that any such measure which entails expenditure in an amount in excess of available and unappropriated state funds shall remain inoperative until 45 days after the next convening of the Legislature in regular session, unless the measure provides for raising new revenues adequate for its operation.” 7 7 The “45 days after the next convening of the Legislature in regular session” language was added to section 19 in 1951 by Me. Const. amend. LXVI. Opinion of the Justices, 460 A.2d 1341, 1350 (Me. 1982). At the time “there was then only one ‘regular session’ of the Legislature, which convened biennially on the first Wednesday of January.” Id. “[T]he amendment avoided the possibility that the 45-day period would be activated by a special session of the Legislature. Thus, the amendment provided ample opportunity for the Legislature to enact funding measures or take any other constitutionally authorized steps by insuring that the 45-day period would commence only at the next regular session after the regular session to which the measure had been presented.” Id. The Legislature was operating with a First Regular Session and a Second Regular Session at the time of the 1982 Opinion of the Justices. See id.; see also Me. Const., art. IV, pt. 3, § 1. The Opinion of the Justices did not address whether the schedule that applied at the time of the 1951 amendment would govern the running of the 45 days, or whether that changed with the later amendment of Me. Const., art. IV, pt. 3, § 1, to establish two “regular” sessions. If the original schedule applied, for 25 [¶46] Section 19 does not specify any remedy if no appropriation is adopted. Considering that, as specified in Sawyer, 109 Me. at 180, the court’s authority to act must be found in our Constitution, section 19 provides no invitation or authority for the courts to mandate funding to implement an unfunded citizen initiative. [¶47] In addition, section 19 does not exempt citizen-initiated legislation from the requirement of Me. Const., art. V, pt. 3, § 4, that no state funds “be drawn from the treasury, except in consequence of appropriations or allocations authorized by law.” The two Constitutional provisions must be read consistently, so that each remains in effect. See Penobscot Nation v. Stilphen, 461 A.2d 478, 481 (Me. 1983) (“We will not read a statute to conflict with another statute where an alternative, reasonable interpretation yields harmony.”). [¶48] Neither the Maine Constitution, nor these precedents, suggests that the courts cannot order the State to pay benefits to individuals who are found to qualify for certain benefit payments when there is an appropriation to support payment of benefits. In Manirakiza v. Department of Health & Human this case, the 45 days would not begin to run until the convening of the new Legislature following the 2018 elections. 26 Services, 2018 ME 10, ¶¶ 7-15, 177 A.3d 1264, the Legislature had appropriated funds to support payment of benefits to certain food stamp applicants, but had imposed a fiscal cap on those benefit payments in the initial years of the program. Manirakiza would have been excluded from eligibility for benefits had he applied for benefits in the years in which the appropriations cap applied. Id. ¶¶ 3, 15. Manirakiza applied for benefits at a time when we held that the appropriations cap had expired. Id. ¶ 15. Accordingly, we held that Manirakiza was entitled to be paid benefits because he qualified for benefits and appropriations had been made to pay for the benefits. Id. ¶¶ 1, 15. [¶49] The appeal was decided based on statutory interpretation of the cap, not constitutional issues. Id. ¶¶ 4, 7-15. Inferentially, the opinion suggests, as a matter of statutory interpretation, that although Manirakiza was eligible for benefits under the particular food stamp program to which he applied, the Court could not and would not have ordered benefits to be paid to him if the cap had applied or if, as is before us today, there was no appropriation at all for the particular program.