126th MAINE LEGISLATURE
		LD 1066		LR 1098(02)
	An Act To Increase Access to Health Coverage and Qualify Maine for Federal Funding
	Fiscal Note for Bill as Amended by Committee Amendment " "
	Committee: Health and Human Services
	Fiscal Note Required: Yes
Fiscal Note
			FY 2013-14	FY 2014-15	Projections  FY 2015-16	Projections  FY 2016-17
Net Cost (Savings)
	General Fund		($689,851)	($3,835,565)	($3,778,658)	$5,226,166
Appropriations/Allocations
	General Fund		($689,851)	($3,835,565)	($3,778,658)	$5,226,166
	Federal Expenditures Fund		$92,152,589	$325,198,201	$341,132,913	$348,902,215
	Other Special Revenue Funds		$4,507,607	$4,635,029	$4,764,278	$4,897,404
Revenue
	Other Special Revenue Funds		$4,507,607	$4,635,029	$4,764,278	$4,897,404
Fiscal Detail and Notes
	This bill implements and adjusts funding related to the expansion of MaineCare under the federal Affordable Care Act.
	Part C requires an evaluation of current state programs to identify savings that would result from the MaineCare expansion, identifies programs and populations that may realize savings and deappropriates funds statewide assuming these savings are then identified and distributed.  The specific programs and amount of savings that will be realized and distributed to each cannot by determined at this time. As a benchmark, the implementation of the MaineCare childless adults waiver effective October 2002 resulted in subsequent savings of $1,800,000 deappropriated in the Mental Health Services - Community program in fiscal year 2002-03 (PL 2001 c.714).   Part C includes deappropriations of $2,700,000 in 2013-14 and $5,900,000 in 2014-15 in the Executive Branch Departments and Independent Agencies -Statewide program in the Department of Administrative and Financial Services for savings to be identified in existing programs as a result of the expansion of MaineCare eligibility.
	Part D of the bill includes General Fund appropriations of $2,010,149 in 2013-14 and $2,064,435 in 2014-15 for the Bureau of Family Independence - Regional program in the Department of Health and Human Services for the state share of the costs of 83 new positions to administer the MaineCare eligibility expansion.  Part D also includes Federal Expenditures Fund allocations totaling $92,152,589 in 2013-14 and $325,198,201 in 2014-15 as detailed below.  The estimated federal allocations assume 100 percent federal matching funds for the first three years of the expansion for both the current childless adult waiver population and the newly eligible adult population below 139% of the federal poverty line and a 97.5 % federal match in 2016-17.  Obtaining a 100% federal match for the current childless adult waiver population and not the "expansion states" federal match (estimated to be 80.78 % in 2013-14 and 82.70% in 2014-15) assumes that under Part B, the Department of Health and Human Services will successfully take the steps indicated by the federal Department of Health and Human Services to secure the "newly eligible" 100% federal match.
			FY 2013-14	FY 2014-15	FY 2015-16	FY 2016-17
	Childless Adults Waiver (below 100% of the Federal Poverty Line)
	Estimated Population	10,500
	Estimated Cost per Year	$5,581	$29,301,300	$61,474,140	$64,486,373	$67,646,205
	Assumed Federal Match		100.0%	100.0%	100.0%	97.5%
	State Share of Costs		$0	$0	$0	$1,691,155
	Childless Adults (Below 139% of the Federal Poverty Line)
	Estimated Population	45,045
	Estimated Cost per Year	$5,581	$62,851,289	$263,724,061	$276,646,540	$290,202,220
	Assumed Federal Match		100.0%	100.0%	100.0%	97.5%
	State Share of Costs		$0	$0	$0	$7,255,056
	Total Federal Allocation		$92,152,589	$325,198,201	$341,132,913	$348,902,214
	Total State share		$0	$0	$0	$8,946,211
	Funding for the new positions included in Part D reflect a 75% federal match for the 64 Eligibility Specialist positions and a 50% federal match for the other new positions.  The funding for the Eligibility Specialist positions assumes a 700 person caseload for each new position.  This is the target caseload the Department of Health and Human Services has identified for the Eligibility Specialist positions.
	This bill does not include appropriations for the MaineCare costs of coverage for the current 19-20 year old population and for the current parents population under 139% of the federal poverty line.  The Department of Health and Human Services has indicated funding for the continued MaineCare coverage for these populations has been included in the MaineCare baseline adjustments reflected in the proposed Governor's 2014-2015 Biennial Budget Bill, LD 1509.