🔒Health risks

‘Tax and match' in jeopardy

• Health provider fees fund Medicaid program

• Super committee eyes abolishment

For years, the state has used a tax on providers of medical services, such as hospitals and nursing homes, to generate some of the cash to match for federal Medicaid funding. But the congressional super committee tasked with reducing the national deficit is looking at capping or eliminating "tax and match" mechanism.

"If the federal government were to move in that direction, it would blow a significant hole in the overall state budget," said Mary Mayhew, commissioner of the Department of Health and Human Services. Many states tax agencies that receive Medicaid to partially fund their overall Medicaid program, she said. "Any significant action in that area by the federal government would greatly exacerbate our financial condition," Mayhew said.

Finance Commissioner Sawin Millett said while it is certain that the state will lose federal funds as the result of the deficit-reduction efforts in Congress, no one knows which programs will be cut, or whether some may be eliminated. "If they either limit the tax and match or eliminate it, we would be in a world of hurt," he said. "We have a hospital tax and match, a nursing home tax and match and a PNMI [private non medical institution] tax and match. We have increased our use of these over the years."

Millett said the provider tax brings in about $57 million, which allows the state to match for more than $100 million in federal funds. Most of the state funds to match for federal money under Medicaid come from general tax revenues. The total state and federal Medicaid expenditures in Maine are over $2 billion a year.

"We are watching closely because what they cut in Washington will have an impact on what we do here in Maine and this could be very significant," said Sen. Richard Rosen, R-Bucksport, co-chairman of the Legislature's budget-writing appropriations committee. He said he has "never been a fan" of the provider tax, but acknowledged that any reduction, let alone elimination, of the mechanism will hurt state finances.

Under the law passed last summer, the super committee must make a package of recommendations to Congress this month that will reduce the deficit by a least $1.2 trillion over 10 years. If Congress does not pass the package, the law requires across-the-board spending cuts to save that amount.

MRS issues opinion on medical pot

• Foods made with marijuana taxed more

• Opponents say move is unfair to patients

Baked or smoked? How patients use their medical marijuana determines at what rate the drug is taxed, according to a recent opinion from Maine Revenue Services.

After Mainers approved expanding the distribution of medical marijuana two years ago, lawmakers decided that it would be subject to the 5% state sales tax. Now Maine Revenue Services says prepared foods such as brownies that include medical marijuana will be taxed at a higher 7% rate.

"It again shows how disconnected some people in the taxing department are from the general will of Maine people," said Paul McCarrier, a board member of Medical Marijuana Caregivers of Maine. He said medical marijuana, as a medicine, should not be taxed at all. For some individuals, eating foods that contain medical marijuana is the best way for them to consume it, as smoking the drug or using vaporizers doesn't work for everyone, McCarrier said. "Sometimes it is the best delivery method for people," he said. "They can ingest it and it helps with their various pains and afflictions. For some people, it is their only delivery means."

Peter Beaulieu, director of the Sales, Fuel and Special Tax Division at MRS, said a provision of the law clearly states the sales tax exemption for medicine does not apply to medical marijuana. "It is MRS's position that a food product containing medical marijuana is not a grocery staple because it is not ordinarily consumed for human nourishment," Beaulieu wrote in the opinion. "The food product being prepared is not for general consumption. It is primarily prepared as an alternative form of delivering the medical marijuana into the body."

He said for prepared foods with medical marijuana to be exempted from taxes would take legislative action. He stressed MRS is just interpreting current law.

"My personal opinion is that it should not be taxed," said Rep. Deborah Sanderson, R-Chelsea, who sponsored legislation passed earlier this year that made several changes to the law allowing dispensaries. "If they were just making brownies as a snack, that's one thing, but this is a way to deliver medicine. For many, this may be the only option because they can't or do not want to smoke marijuana."

Rep. Anne Haskell, D-Portland, served on the task force two years ago that drafted the dispensary legislation following the referendum vote, and said the Legislature should consider the issue.

LePage seeks child labor law changes

• Criticizes work permit inefficiencies

• Continues push for training wage

Gov. Paul LePage says the state should leave decisions about employment outside of school hours up to children and their parents, and is seeking to streamline the work permit process.

"I don't see why kids can't go to work when they are 14 or 15," he said. "I'm talking about summer months and vacation, not when they are in school."

LePage said he has heard from several parents about how long it takes to get a work permit for vacation periods from school. In one case, a teen had a job lined up, but had to wait weeks for a permit. "Three weeks to get through the superintendent to the Department of Labor to get a permit. That's outrageous," LePage said.

Instilling a good work ethic in teens helps them through their adult life, the governor said, and not all kids can handle a job and school at the same time, so it is important they can work during vacation periods if they choose. All other protections in child labor law, like the prohibition against working around dangerous machinery, should remain in place, LePage said.

He also added that more teens could join the work force right out of high school if employers could pay them a lower starting wage. "I think we would see more hired and have jobs if they could be paid a training wage as they learned the skills they needed for a job," LePage said.

Rep. David Burns, R-Whiting, sponsored a bill aimed at loosening limitations on teens working while in school. He said he would have addressed the governor's concerns about the work permit process if he had been aware of them earlier this year. "I didn't try to go after everything," he said. "I think the governor has a good idea and we should consider it."

Rep. Robert Hunt, D-Buxton, who serves on the Labor, Commerce, Research and Economic Development Committee, said the permitting process provides needed protections for children. "It's there to make sure they are not being taken advantage of, they are not working more hours than they should," he said. "These are important things we put into law because at some point in the past, somebody didn't do what they should for kids."