Gov. Paul LePage is continuing to fight Medicaid expansion in court, filing another motion to delay the case only five weeks before Gov.-elect Janet Mills will take over, reverse course and implement the expansion.

As a result, LePage’s latest legal move may do little more than further delay access to health insurance for the 70,000 people who will be eligible for Medicaid coverage under the law approved by voters in November 2017.

On Monday, the Maine Department of Health and Human Services requested a stay of a judge’s order that would compel the LePage administration to move ahead with Medicaid expansion. 

Superior Court Justice Michaela Murphy ruled Nov. 21 that Maine DHHS had to implement expansion by Dec. 5, a move that would make about 70,000 low-income Mainers eligible for health insurance. Murphy ruled that the LePage administration had to follow the law approved by voters, but LePage has said the state will appeal the ruling.

The stay request, filed Monday with the state’s Business and Consumer Court, argued that implementing expansion would have “far-reaching negative consequences” and would “prompt a fiscal crisis by requiring the expenditure of funds needed to provide care for the even poorer population that currently receives (Medicaid) services.”

Medicaid expansion will cost state taxpayers about $50 million to $60 million per year, but Maine will receive more than $500 million annually in federal funds to help pay for health care for newly eligible Medicaid enrollees. The Legislature approved $60 million in funding for Medicaid expansion this summer, but LePage vetoed it, arguing that the funding package contained one-time “budget gimmicks.”

Voters approved Medicaid expansion — a key component of the Affordable Care Act — 59 to 41 percent in the 2017 referendum, but LePage has refused to implement it, arguing that funds were not available to do so. The Republican governor has been a steadfast Medicaid expansion opponent, having vetoed several expansion bills passed by the Legislature. 

Mills, a Democrat, has vowed to implement Medicaid expansion “on day one” if it has not already been put in place when she assumes office in January.

When LePage refused to implement expansion this past spring, Maine Equal Justice Partners, the advocacy group that lobbied for the 2017 referendum, filed suit, arguing that the governor did not have the authority to avoid implementing a voter-approved law. The courts have so far ruled in Maine Equal Justice Partners’ favor.

In her Nov. 21 decision, retroactive to July 2, Murphy wrote that “although the governor may believe implementation to be unwise and disagree with the (expansion law) as a matter of policy, he may not ignore the will of the people and refuse to take any action toward accomplishing the policy objectives of the (law).”

Attorneys for LePage argued in the motion asking for a stay Monday that the state could lose millions in federal money if the stay is not granted. They said that because the federal government has yet to approve the state’s expansion plan, Maine would be at risk of paying the full cost of expansion from July through December, instead of 10 percent of the cost as required by the Affordable Care Act.

But MaryBeth Musumeci, the associate director of the Program of Medicaid and the Uninsured at the Kaiser Family Foundation, a national health policy think tank, told the Press Herald that as long as an “approvable” plan is filed in the same quarter that expansion begins, the federal government would retroactively reimburse any costs to the state within the same quarter.

The LePage administration filed its plan with the U.S. Centers for Medicare and Medicaid Services in September, so as long as the routine paperwork is considered “approvable” Maine would not lose any federal funds, Musumeci said.

Robyn Merrill, executive director of Maine Equal Justice, said that even though Mills will be taking over soon, the organization’s goal is to “get health care to people who need it as quickly as possible.”

“We have a new administration coming in that believes in and values Medicaid expansion and is ready to make it happen,” Merrill said. “It’s still important to hold (the LePage) administration accountable and comply with the decision issued by the court. That decision should become a court precedent and must be allowed to stand.”

Mills spokesman Scott Ogden said in a statement that “Medicaid expansion is the law of the land, and regardless of what the current administration does between now and January, Governor-elect Mills will immediately take steps to implement it as soon as she assumes office, as the people of Maine have demanded.”

Under the law, Mainers earning as much as 138 percent of the federal poverty level — $16,753 for an individual and $34,638 for a family of four — could begin applying for Medicaid coverage July 2. Many did, only to receive letters of denial from DHHS.

Gov. Paul LePage