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Rep. Dean Cray Seeks to End Health Care ‘Scam’ by State Employees

AUGUSTA – According to State Rep. Dean Cray, 175 state employees with fully paid health insurance are instead using the MaineCare system, the state’s name for Medicaid. He said full-time workers with an excellent health plan prefer Medicaid because there are no co-pays, while the state health program requires co-pays of $10 or $15.

Rep. Cray said some state employees are “scamming the system,” and he hopes to end it with LD 1302 – “An Act to Prohibit Full-time State Employees from Enrollment in MaineCare.” He formally presented the bill on April 28 to the Legislature’s Health and Human Services Committee.

In committee testimony, he explained that he learned about the co-pay avoidance scheme last year while handling a constituent service matter. “In casually talking with the state employee,” he said, “she divulged that she used MaineCare for her insurance so that she would not have to pay co-payments for medical services. I hung up the phone, hardly believing what I had just heard.”

Rep. Cray told the committee that further investigation revealed that approximately 175 state employees were receiving MaineCare benefits, along with and 85 retired state employees. He attached a list for the committee’s review.

Private sector employees are exploiting Maine’s generous Medicaid system, too, he said. “Some employees have the option with their employers to receive additional pay in lieu of receiving insurance coverage under their employer’s plan,” he said. “They pocket the money and then turn around and enroll in MaineCare. That should not be allowed to happen and needs to be one of the first areas of the MaineCare system we fix.”

Rep. Cray has bipartisan support for the proposal, and he think his bill’s chances are good due to the state’s massive budget shortfall. “We need to look at restructuring MaineCare,” he said. “When the safety net is bigger than the net itself, maybe we need to look at what we are doing and who is actually receiving state-paid benefits that are supposed to be going to Maine’s poorest citizens.”

MaineCare has about 270,000 enrollees and costs about $2.4 billion per year, with some of the expense paid by the federal government. The last time Maine experienced a major budget crisis, in 1991, MaineCare had 110,000 members.

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