RGA versus the MOE

At some point tonight the Sun Journal will be posting a story about how some of Gov. Paul LePage’s proposed Medicaid cuts will require a waiver from the Affordable Care Act’s so-called Maintenance of Effort (MOE) provision.

To this point the federal HHS has not approved any waiver requests by any states. That’s important, but so are the politics, which are not included in tonight’s story.

The MOE essentially prohibits states from cutting or limiting eligibility to certain Medicaid programs until the federal health care law goes into effect in 2014. The intent is to make sure certain people receive health care benefits until that time. 

Republican governors, including LePage, have been railing against the MOE since the 2010 wave elections swept several GOP governors into power. Their argument, coordinated through the Republican Governors Association, is that the ACA ties states’ hands and forces them to keep unsustainable Medicaid programs.

Earlier this year 33 governors and governors-elect, including LePage, sent a letter to HHS Secretary Kathleen Sebelius requesting more latitude with the MOE:

The effect of the federal requirements is unconscionable; the federal requirements force Governors to cut other critical state programs, such as education, in order to fund a ‘one-size-fits-all’ approach to Medicaid. Again, we ask you to lift the MOE requirements so that states may make difficult budget decisions in ways that reflect the needs of their residents.

Democrats have countered that the RGA attack on the MOE is an extension of Republicans’ attempt to dismantle the federal health care law.