128th MAINE LEGISLATURE
		LD 1039		LR 2279(01)
	An Act To Enhance Access to Affordable Health Care
	Fiscal Note for Initiated Bill
	Committee: Not Referred
	Fiscal Note Required: Yes
Fiscal Note
Current biennium cost increase - General Fund Current biennium cost increase - Federal Expenditures Fund Current biennium revenue increase - Federal Expenditures Fund
Fiscal Detail and Notes
	This citizen initiative expands medical coverage under the MaineCare program to adults who qualify under federal law with incomes up to 133% plus 5% of the nonfarm income official poverty line. The initiative will require annual General Fund appropriations of $2,578,609 for the Office of Family Independence - District program in the Department of Health and Human Services (DHHS) for the state share of the costs of 103 new positions to administer the MaineCare eligibility expansion.  Funding for the new positions reflects a 75% federal match for the 79 Eligibility Specialist positions and a 50% federal match for the other 24 new positions.  The funding for the Eligibility Specialist positions assumes a 700 person caseload for each new position. The initiative will require annual General Fund appropriations of $50,366,696 to the DHHS for medical costs for the newly eligible childless adult population. This amount represents 10% of the total cost, with federal matching funds used for the remaining 90%. The initiative will require annual General Fund appropriations of $28,139,957 to the DHHS for medical costs for the parent's population between 101% to 138% of the federal poverty level. This amount represents 35% of the total cost, with federal matching funds used for the remaining 65%. The initiative will require annual General Fund appropriations of $409,745 to the DHHS for medical costs for the children who have not had MaineCare in the past, but whose family will opt for MaineCare coverage after expansion. This amount represents 2% of the total cost, with federal matching funds used for the remaining 98%.
	Although overall costs will increase under this initiative, some programs will achieve savings that will mitigate the additional expenditures. The savings that are generated within existing programs are estimated to be $27,000,000 annually and are already taken into account in the summary of costs and revenues in this fiscal impact statement.
	Additional costs for the Legislature's Office of Fiscal and Program Review for certain review and reporting functions can be absorbed within existing budgeted resources. In summary, when fully implemented, this initiative is anticipated to require net annual appropriations from the General Fund of $54,495,000. Federal costs would be around $525,000,000 annually. If approved by the voters, additional implementing legislation will be required to provide the additional appropriations and allocations.