AUGUSTA — As lawmakers on Tuesday dissected the causes of a projected $220 million budget shortfall in the state’s Department of Health and Human Services, the political jockeying stepped up in earnest over the LePage administration’s proposal to remove more than 65,000 Mainers from the state’s Medicaid program.

Lawmakers on the Legislature’s budgetary committee grilled DHHS staff on the eve of public hearings expected to draw large crowds protesting LePage’s plan. Tuesday’s work session was packed with complex budgetary data as panelists attempted to determine how much of the gap was the result of one-time overruns or structural problems in the Medicaid program.

The divergence in the two causes set the stage for the political battle that will unfold over the next week. The LePage administration, bracing for blow-back against one of its key policy initiatives, blamed the shortfall on the administration of Gov. John Baldacci.

The LePage administration also sent several media releases combating speculation by Democrats that the governor was overstating the budget shortfall to advance reckless reductions that would leave thousands without medical coverage.

But LePage said the gap was the result of the previous administration using one-time, federal stimulus funds to pay for Medicaid. It also said previous decisions to defer reimbursement to the state’s hospitals exacerbated systemic shortfalls.

Earlier this year, the LePage administration ordered the state to repay $148 million to the hospitals. In a news release, the governor said the state would not be facing as large a hole if the hospitals had been repaid earlier.

“Instead of a $220 million shortfall, we’d be looking at around $90 million,” he said.

The administration also said previous Democratic leadership had expanded Medicaid benefits far beyond the national average, creating increased utilization and an unsustainable Medicaid program.

Meanwhile, Democrats and progressive groups continued to question the size of the budget gap and the administration’s claim that its numbers had been confirmed by independent analysis by the Office of Fiscal and Program Review.

Chris Nolan, of the Office of Fiscal and Program Review, was asked by lawmakers on the Appropriations Committee whether the administration’s analysis of the shortfall matched his calculations. Nolan told the panel he could see how the administration arrived at the $220 million, but that calculating various reimbursement rates could reduce the size of the gap.

As the administration sought to reaffirm its calculations, Democrats played up their uncertainty over the magnitude of the gap.

Rep. John Martin, D-Eagle Lake, said it was apparent from the testimony by DHHS staff that the administration should share some of the blame for the shortfall.

“We learned today that the budget hole was partially caused by poor planning and questionable assumptions from the administration,” Martin said in a statement.

Martin and Democrats also challenged the administration’s claim that MaineCare, the state’s Medicaid program, was suffering from increased use. They cited data provided by the administration showing that enrollment increases accounted for $6.5 million of the $220 million shortfall.

According to MaineCare caseload data compiled since January, enrollment has increased by 2 percent this year.

“We don’t have a problem of increased enrollment of MaineCare,” Martin said. “Contrary to the governor’s rhetoric, what we have here is a realization of a failure to plan nearly a year into the governor’s tenure.”

Democrats also claimed the administration underestimated the cost of assisted-living facilities and did not plan for the loss of one-time federal grants. 

The administration used stimulus funding to repay the hospitals.

Some wondered why lawmakers were dealing with the DHHS shortfall as a separate problem when the Legislature still hasn’t funded the tax breaks it approved last session.

The tax cut package, which progressive groups say mostly benefits wealthy Mainers, will cost nearly $200 million in fiscal year 2013. Those same organizations question funding those cuts while eliminating health care coverage for the poor, seniors and people with disabilities.

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