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By Dave Sherwood
BOWDOINHAM, Maine (Reuters) - Maine's Democratic-controlled legislature on Thursday passed a bill to expand access to its Medicaid program as outlined by the Affordable Care Act, setting up a showdown with the state's Republican governor, who immediately began veto procedures.
At issue is lawmakers' effort to link expanded access to the health insurance program for low-income residents to a plan to pay the state's share of $484 million in debt owed to Maine's hospitals.
Governor Paul LePage, who is frequently in conflict with state legislators, has insisted the two issues remain separate and signed a letter to veto the bill within minutes of its passage.
"Democrat leadership has spent the past week forcing this bill through the legislative process," LePage said in his veto letter. "This unadulterated partisanship tied two different issues together in a quest to force welfare expansion upon the Maine people."
LePage submitted a bill that would tackle the hospital debt that does not include Medicare expansion.
The LePage administration has begun negotiation with the federal government regarding the mandates in the 2011 healthcare reform law that is President Barack Obama's signature domestic legislative achievement.
About 15 U.S. states have said they will not participate in the expansion of Medicaid, with 26 opting in and the balance not yet decided, according to the Advisory Board Company, a consulting firm that tracks the issue.
Texas lawmakers on Tuesday passed a measure, backed by Republican Governor Rick Perry, to block the state from participating in Medicaid expansion.
Maine legislators had proposed to use a portion of future revenue from a renegotiated state liquor contract to pay $484 million in debt due Maine's 39 hospitals. That proposal was initially supported by both parties, but Republicans turned against it last week after it was amended to increase Medicaid access.
Democrats said the move would expand health care coverage to an estimated 70,000 Maine citizens.
Under the Affordable Care Act, the federal government agreed to increase Medicaid eligibility and cover 100 percent of the costs for three years, after which coverage would be reduced to 90 percent. According to a previous analysis from Maine's Department of Health and Human Services, Maine taxpayers would be on the hook for an additional $75 million per year after federal reimbursement drops to 90 percent.
Mark Eves, speaker of the Maine House of Representatives and a Democrat, said the bill "pays the debt and helps fix the underlying problem that contributes to high health care costs in the first place," citing rising costs of charity care in emergency rooms of Maine hospitals.
LePage made a surprise appearance at a Sunday meeting of a legislative committee on Medicaid but lawmakers did not allow him to speak.
"The repeated attempts by Democrats to stifle debate on bills and to prevent me from speaking in front of the Appropriations Committee is a disturbing pattern of censorship that should concern all Mainers," LePage said in a statement.
(Editing by Scott Malone and Dan Grebler; Editing by David Gregorio)