AUGUSTA, Maine ? After a four-hour debate Tuesday, the House of Representatives approved a bill that would pay off Maine's $484 million debt to the state's hospitals, agreeing to go along with a Democrat-backed amendment calling for the state to accept federal money to expand Medicaid to roughly 70,000 people.
The bill won approval by an 87-57 vote, following Senate approval earlier in the day. The bill faces final votes in both chambers.
Supporters, including House Speaker Mark Eves, described the bill as a "win-win" that would settle a nagging debt to the hospitals for unpaid Medicaid services, while expanding the state's economy and providing health coverage to uninsured Mainers whose earnings are no more than 138 percent of the federal poverty level.
"It's a good deal, and it's one we must not walk away from," said Eves, D-North Berwick, who left the House rostrum to speak. "It's morally and economically the right thing to do."
Eves said passage of the bill would help to address a major cause of rising health care costs. He said Maine hospitals have reported they provided $450 million in charity care and bad debt last year. Also to bolster their arguments, the Democrats gave examples of low-income, working Mainers who have been left out of health care coverage.
Rep. James Campbell, an independent from Newfield, reminded lawmakers that they benefit from taxpayer-paid health coverage, and "it's time we step up to the plate" for people who can't afford it.
Republican opponents failed in a string of attempts to derail or delay the bill on parliamentary grounds.
House GOP leader Kenneth Fredette sought to persuade lawmakers to remove Medicaid expansion from the bill, adding there was no assurance his fellow Republicans would oppose it if it is to be taken up separately. Other Republicans said the expansion of Medicaid, known in the state as MaineCare, has not been sufficiently studied by lawmakers.
"We do not have all the information we need to make the wisest choice," said Rep. Deborah Sanderson, R-Chelsea.
The bill would pay the state's share of the hospital debt for past Medicaid services, $186 million, with money from future state liquor sales. The federal government would pay the remaining $298 million to settle the longstanding debt. Paying the hospital debt has been a top issue for Republican Gov. Paul LePage, who has repeatedly demanded quick legislative action.
Some Democrats even praised the governor for forcing the hospital debt issue to a vote. But LePage has opposed the Medicaid expansion.
The bill expansion would take place as part of the national Affordable Health Care Act. Majority Democrats said the government will pay 100 percent of expansion for the first three years and 90 percent after that, but Republicans counter that there's no guarantee that will happen and that expansion would actually cost the state millions of dollars per year.
The measure would pay Maine's share of the hospital debt with a revenue bond to be paid back with proceeds raised through a renegotiated liquor sales contract.
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