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Proposed cuts to health initiatives, childcare and other supports blasted in budget hearing

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Proposed cuts to health initiatives, childcare and other supports blasted in budget hearing

Feb 27, 2024 | 5:06 am ET
By Evan Popp
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Proposed cuts to health initiatives, childcare and other supports blasted in budget hearing
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Gov. Janet Mills, a Democrat, released her $71 million spending addition to last year’s biennial budget earlier this month. (Jim Neuger/Maine Morning Star)

Advocates and some lawmakers on Monday sharply criticized aspects of Gov. Janet Mills’ supplemental budget plan that would delay or cut health expansion initiatives, child care subsidies and social service programs. 

Mills, a Democrat, released her $71 million spending addition to last year’s biennial budget earlier this month. The plan includes investments in public safety, health care, housing, and child welfare, but also proposes stashing $107 million in a new reserve for the next biennium — a provision both progressives and conservatives have criticized

The budget is now in the hands of the Legislature’s Appropriations and Financial Affairs Committee, which on Monday held a joint hearing with the Health and Human Services Committee on health care-related spending within the plan.

Department of Health and Human Services Commissioner Jeanne Lambrew, who represented the Mills administration at the hearing, told lawmakers that the budget proposal appropriately weighs current needs with fiscal caution. 

Conservatives, progressives alike object to $107M savings in Mills’ budget proposal

“The supplemental budget is balanced, prudent and responsible, and it advances the governor’s long-held belief that we must continue to invest in the people of Maine — our greatest asset,” Lambrew said. “That is why the governor’s proposal strikes the balance between making timely investments to address urgent needs — like public safety, mental health, housing, education and health care — and saving money to ensure that our state continues to stand on strong financial fiscal footing.” 

However, many of those testifying at Monday’s hearing were not convinced, arguing that while the budget contains many admirable investments, several provisions would be detrimental to vulnerable Mainers. 

Medicare Savings expansion rollback

One frequent target of those testifying was Mills’ proposal to rollback an expansion of the Medicare Savings Program that was approved as part of last year’s biennial budget. The expansion aims to help low-income retirees by raising the threshold for income eligibility and eliminating an asset test. It was supposed to be implemented by March 1, opening the program up to 19,000 additional people. 

Lambrew said the administration believes with state revenues slowing — along with high drug costs and an aging population — the expansion would not be sustainable. 

Many testifying blasted the proposed reversal, though. Fran Seeley of Portland said the program would lead to thousands of dollars in savings for older Mainers. In her case, Seeley said it would provide her with sufficient funds to pay her electricity and heating bill. 

Seeley argued that Mills’ proposal to halt the expansion and save the state $14 million would create those savings “on the backs of financially-vulnerable, lower-income Mainers.”

“This is a social injustice we must not allow,” she said. 

Jess Maurer of the Maine Council on Aging added that older residents are struggling with the rising costs of food, housing, health care and other basic necessities and that providers are seeing an increase in evictions of such people. Rolling back the Medicare Savings Program expansion is the last thing older Mainers need, she said. She also noted that although Maine would save $14 million by nixing the expansion, it would also forfeit $38 million in matching federal dollars. 

Child care program delays

Proposed delays in state funding meant to stabilize the child care workforce also came under heavy criticism. 

Providers have repeatedly told lawmakers that the state’s child care industry is in crisis, with facilities operating on extremely tight margins that makes it difficult to adequately pay workers, leading to staffing shortages that create a lack of available slots for families. 

To help address the issue, lawmakers and Mills in last year’s biennial budget doubled stipends for child care workers and also provided an ongoing stipend to child care workers with young children in the subsidy program in an effort to recruit and retain staff. 

After telling providers that the doubled stipend would be available this spring, Mills has proposed delaying implementation until July 1 and also asked the Legislature to turn the child care worker subsidy program into a limited two-year initiative. 

I hear a lot about how Maine won’t wait, but it seems like on this issue, Maine is definitely waiting. The situation in Maine regarding childcare is dire. … The last thing that we should be doing is going back on our commitments or scaling back our relief.

– Senate President Troy Jackson

Lambrew emphasized that the state is not doing away with either of those programs but simply needs more time to implement them. 

But that didn’t go over well with providers.

“It’s little wonder folks lose faith in state government,” said Chrissie Davis, a child care provider in Skowhegan, in testimony read by another person. “Child care providers are real people, serving real people’s children on a daily basis [and] trying to pay our ever increasing bills each week. We don’t have the luxury of pushing our financial obligations off for months or a year.” 

Senate President Troy Jackson (D-Aroostook), who sponsored the initial bill to double worker stipends, also blasted Mills’ proposal. 

“I hear a lot about how Maine won’t wait, but it seems like on this issue, Maine is definitely waiting. The situation in Maine regarding childcare is dire. … The last thing that we should be doing is going back on our commitments or scaling back our relief,” Jackson said. 

Change in food stamps eligibility

Mills’ proposed budget also removes a provision within the Supplemental Nutrition Assistance Program (SNAP) that allows asylum seekers to receive benefits while they are looking for employment after receiving their work authorization. 

Mills’ budget does include $5.4 million in SNAP funding due to increased enrollment in the program. But the proposal to eliminate the hardship exemption — the initiative that allows people to receive benefits after getting work authorization — sparked significant pushback.  

DHHS said the proposal is to help control costs while ensuring others can continue to access the program. 

Rent relief, election support, teacher raises dominate week one of budget hearings

But Simane Ibrahim of Maine Access Immigrant Network said the change would cause significant problems. She noted that there is often a significant delay between when immigrants receive work authorization and when they get a job. The SNAP program is a crucial bridge that helps people survive during that time, she said. 

“We have people who come to us who are starving,” Ibrahim said.

“This is a retraumatization, it’s inhumane,” she added of Mills’ proposal.   

Kathy Kilrain del Rio of Maine Equal Justice also criticized the plan, calling the elimination of the hardship exemption egregious given the frequent delays in people finding jobs. And along with rejecting that proposal, she called for lawmakers to ensure all immigrants can access MaineCare benefits, a long-time goal of health care advocates that was not included in Mills’ budget plan.  

General Assistance program adjustments

Mills’ budget proposed adding $5 million to reimburse municipalities for general assistance program costs, which is meant to be a program of last resort to help people meet basic needs such as food, housing and utilities. 

Municipalities and advocates said those funds are needed. But they asked lawmakers to strike another part of the governor’s budget that would prevent municipalities from exceeding the maximum amount of assistance to any applicant for more than one month within a year-long period. 

Portland Mayor Mark Dion spoke against the proposed change. While he said he agrees with one of the Mills administration’s stated reasons for the reform — to move away from putting unhoused people up in hotels because of the expense of that solution — he argued municipalities need the ability to stay flexible enough to help those struggling with housing insecurity. 

“This cap [on GA assistance levels], by its very nature, threatens our ability to respond to those needs,” Dion said. 

Nursing homes and residential care challenges 

In her budget, Mills also proposed a $10 million allocation to support rate reimbursement reform for nursing facilities — a sector that has faced many of the same challenges as the child care industry — in an attempt to incentivize staff retention and spur high quality service.

Maine Health Care Association President Angela Westhoff said while she appreciates that proposed investment, it’s not enough to support the needs of the nursing home workforce. Westhoff said inflation, a labor shortage and an aging population mean the cost of providing nursing and residential care has skyrocketed and that MaineCare reimbursement rates continue to lag behind. That’s a significant reason why she said nine nursing homes have closed in the last three years alone

Although reforms to reimbursement rates are slated to begin in 2025, Westhoff said nursing and residential care facilities need help now, telling lawmakers that a $31 million allocation would provide a meaningful start toward addressing the issues such centers face.  

“If the budget advances as drafted, Maine will continue to lose access to nursing homes and residential care facilities,” she warned.