AUGUSTA — A group of Republican lawmakers led by former Maine Senate President Rick Bennett is asking Secretary of State Matt Dunlap to strike the word “insurance” from a ballot question that will ask voters in November to expand the state’s Medicaid program under the federal Affordable Care Act.

Bennett, also a former chairman of the Maine Republican Party, said at a news conference Tuesday that the proposed question, which is currently under a public comment period, should describe the expansion as either “taxpayer-funded health benefits” or as “government-funded health benefits” but not as insurance.

But supporters of the expansion said there was little question that Medicaid is a health insurance program for the poor, even though opponents prefer to label it “medical welfare.”

Bennett said Tuesday’s event was not the launch of an opposition campaign but an effort to draw attention to a four-page letter he and expansion opponents had sent to Dunlap asking him to consider a wording change to the ballot question. The question now reads:

“Do you want Maine to provide health insurance through Medicaid for qualified adults under the age of 65 with incomes at or below 138 percent of the federal poverty line (which is now about $16,000 for a single person and $22,000 for a family of two)?”

Currently, 19- and 20-year-olds, individuals with disabilities, the elderly and certain low-income parents qualify for Medicaid, which operates as MaineCare.

Lawmakers in attendance Tuesday included Assistant House Minority Leader Ellie Espling, R-New Gloucester, and Republican Reps. Heather Sirocki of Scarborough, Phyllis Ginzler of Bridgton, Paula Sutton of Warren, and Stephanie Hawke of Boothbay Harbor. The group said the state’s price tag for the change, estimated at about $54 million a year in the bill’s fiscal note, should also be included in the question.

“A welfare expansion will take money from Maine taxpayers, from their pockets and put it into the pockets of others who are not disabled and are working-aged adults,” Sirocki said.

Robyn Merrill, executive director of Maine Equal Justice Partners, a nonprofit that advocates for the poor and led the petition drive for the ballot question, said Sirocki is wrong. Merrill said Medicaid doesn’t provide cash payments to those who would be covered under the expansion, but instead reimburses health care providers, including Maine hospitals, many of which are struggling to cover the cost of the state’s uninsured as charity care.

Merrill and other supporters acknowledge the proposal’s $54 million annual price tag. However, they say that opponents frequently fail to mention that expansion would draw down $525 million each year in federal matching funds, while saving the state an estimated $27 million a year in costs once it is fully implemented.

In all, 31 states have expanded their Medicaid programs under the Affordable Care Act, including a number with legislatures controlled by Republican majorities and headed by Republican governors.

Maine Equal Justice Partners gathered more than 67,000 signatures of registered Maine voters in 2016 to put the Medicaid expansion question on the Nov. 7 ballot.

The Affordable Care Act, which passed in 2010, offers reimbursement rates for Medicaid expansions that taper from 100 percent to 90 percent in 2020. Since the ACA became law, the Maine Legislature has voted to expand Medicaid five times, only to see those expansions vetoed by Gov. Paul LePage – with support from minority Republicans in the House.

“The majority of the Legislature has passed this, it has been vetted,” Merrill said, “but the important thing is more people would have access to affordable health care.”

Merrill rebutted claims that Medicaid was not a health insurance program. “I disagree with the claim this isn’t insurance. Ask anybody who is covered by Medicaid – this is health insurance. Over 265,000 Maine people are covered by Medicaid and this is health insurance,” Merrill said. About one out five Mainers is now insured under the program.

Kristen Muszynski, a spokeswoman for Dunlap, said he would be reviewing all responses during a public comment period but not discuss specific concerns about wording.

The public comment period on the question’s wording closes at 5 p.m. on Sept. 1.

Bennett said he had no ulterior motives for entering the public fray over the ballot question and does not plan to run for office. Bennett had been considered a possible candidate for the governor’s race in 2018, and earlier this year said he was considering that, but on Tuesday he ruled that out as well.

“I’m not here for a campaign. I’m here as a former legislator, as a businessman, as a father and as a citizen who is just concerned about his state,” Bennett said.

As of Tuesday, no formal opposition to the ballot question had registered with the Maine Ethics Commission as a ballot question committee or as a political action committee, as required under state ethics and campaign finance laws.

LePage has also been an outspoken critic of expanding Medicaid in Maine in recent weeks, telling radio talk show hosts the expansion would be devastating to the state’s budget. LePage also once described Medicare and Social Security, which are funded with payroll taxes charged to employers and employees, as welfare.

In 2014, LePage’s office issued a press release after a report from the U.S. Bureau of Economic Analysis showed Maine’s personal income growth was below the U.S. average and last in New England. The release said the BEA report “claims the other five New England states saw higher personal income growth than Maine, but that growth was driven by an increase in welfare benefits, especially in the form of Medicaid expansion. The BEA conceals welfare benefits by calling them ‘Personal Current Transfer Receipts.’ These ‘Transfer Receipts’ include: Social Security benefits; Medicare payments; Medicaid; and state unemployment insurance benefits.”

LePage continued: “It doesn’t matter what liberals call these payments, it is welfare, pure and simple. Liberals from the White House all the way down to Democratic leadership in Augusta believe that redistribution of wealth – taking money from hard-working taxpayers and giving it to a growing number of welfare recipients – is personal income. It’s not. It’s just more welfare expansion.”

The governor, who was then running for re-election, later accused the Portland Press Herald of making an “erroneous interpretation” of his statement and sought to clarify, saying he didn’t believe Social Security and Medicare were welfare.

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