LD 2208

132nd MAINE LEGISLATURE
  SECOND REGULAR SESSION-2026
Legislative Document  No. 2208
H.P. 1487  House of Representatives, February 10, 2026
  An Act to Offset Federal Cuts to Health Insurance for Certain
  Maine Families and Seniors
   Approved for introduction by a majority of the Legislative Council pursuant to Joint Rule
203.
   Reference to the Committee on Health and Human Services suggested and ordered printed.
  ROBERT B. HUNT
  Clerk
Presented by Speaker FECTEAU of Biddeford.
Cosponsored by President DAUGHTRY of Cumberland and
Representatives: CLUCHEY of Bowdoinham, DODGE of Belfast, JULIA of Waterville,
MATHIESON of Kittery, RAY of Lincolnville, Senators: GROHOSKI of Hancock, RENY of
Lincoln, TIPPING of Penobscot.
  Printed on recycled paper
1 Be it enacted by the People of the State of Maine as follows:
2     Sec. 1. 22 MRSA §1730-B is enacted to read:
3 §1730-B. Rural Hospital Stabilization Program
4      1. Program established. The Rural Hospital Stabilization Program, referred to in this
5 section as "the program," is established within the department to provide grants to defray
6 operating costs for health care providers and health care facilities in rural areas, including
7 start-up costs, incurred in providing inpatient, outpatient, primary, specialty or behavioral
8 health care services to residents of the State and to stabilize the provision of existing health
9 care services when those services are at risk of reduction or elimination. For the purposes
10 of this section, "rural area" has the same meaning as in section 5304, subsection 18.
11      2. Rural Hospital Stabilization Fund. The Rural Hospital Stabilization Fund,
12 referred to in this section as "the fund," is established as a dedicated, nonlapsing fund
13 administered by the department for the purposes of funding the program. The department
14 may receive money from any gift, grant, contribution, legislative appropriation, allocation
15 or transfer or bond proceeds. The money in the fund may be used only for the purposes of
16 awarding grants under the program and paying program administration costs.
17     3. Program eligibility. The department shall award grants from the fund, which are
18 subject to the following conditions and limitations.
19     A. The health care provider or health care facility must meet state licensing
20     requirements to provide health care services and must be an enrolled Medicaid provider
21     that actively serves Medicaid recipients in a rural area.
22     B. Grants must be for at least one year and for no more than the first 5 years of
23     operation as a newly constructed health care facility in a rural area or the operation of
24     a new or expanded health care service in a rural area.
25     C. Grants must be limited to covering operating costs for which revenue is not
26     sufficient.
27     D. The health care provider or health care facility must provide evidence to the
28     department that the receipt of a grant under this section would help the health care
29     provider or health care facility reopen services that have closed due to cost constraints
30     or would help keep existing services open.
31     E. The health care provider or health care facility must provide adequate cost data, as
32     defined by rule by the department, based on financial and statistical records that can be
33     verified by qualified auditors. The data must be based on an approved method of cost
34     finding and the accrual basis of accounting and be confirmed as having been delivered
35     through review of claims.
36     F. Grant award amounts must be reconciled by the department to audited operating
37     costs after the close of the grant period.
38     G. In the case of a health care provider, the provider must commit to:
39(1) A period of operation equivalent to the number of years grants are awarded;
40and
41(2) Actively serve Medicaid recipients in a rural area throughout the duration of
42the grant period.
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1     H. In prioritizing grant awards, the department must consider the health needs of the
2     State and the locality in which the health care facility is located and long-term
3     sustainability of the new or expanded health care service.
4     I. Grants from the fund may not be used for operations outside of the State.
5     4. Rulemaking. The department may adopt rules to implement this section. Rules
6 adopted pursuant to this subsection are routine technical rules as defined in Title 5, chapter
7 375, subchapter 2-A.
8     Sec. 2. 22 MRSA §3198 is enacted to read:
9 §3198. Health Care Premium Stabilization Fund
10      1. Fund established. The Health Care Premium Stabilization Fund, referred to in this
11 section as "the fund," is established as a dedicated, nonlapsing fund administered by the
12 department to maintain coverage for residents of the State through the Maine Health
13 Insurance Marketplace, established in chapter 1479, Medicaid or other federal assistance
14 programs if the federal Patient Protection and Affordable Care Act, Public Law 111-148
15 and 42 Code of Federal Regulations, Part 455 are repealed or are administered in a way
16 that reduces access to comprehensive health coverage for residents of the State.
17     2. Sources of fund. The fund consists of amounts appropriated or allocated by the
18 State. The department may receive money from any gift, grant, contribution, legislative
19 appropriation, allocation or transfer or bond proceeds.
20     3. Uses of fund. The department shall use the fund to establish a state subsidy to offset
21 the financial impact of the expiration of the enhanced premium tax credits under the
22 American Rescue Plan Act of 2021, Public Law 117-2. The subsidy must be used to
23 increase the amount of assistance available to those previously eligible for subsidies under
24 the federal Affordable Care Act, Public Law 111-148 and to expand assistance to those
25 with an income at or below 400% of the federal poverty level if the recipient's premium
26 cost of a silver category health insurance plan under the federal Affordable Care Act would,
27 prior to the receipt of a subsidy under this section, exceed 8.5% of the recipient's household
28 income.
29     4. Rulemaking. The department may adopt rules to implement this section. Rules
30 adopted pursuant to this subsection are routine technical rules as defined in Title 5, chapter
31 375, subchapter 2-A.
32     Sec. 3. 22 MRSA §3199 is enacted to read:
33 §3199. MaineCare Federal Response Fund
34     1. Fund established. The MaineCare Federal Response Fund, referred to in this
35 section as "the fund," is established as a dedicated, nonlapsing fund administered by the
36 department to supplement funding for the MaineCare program in the case of funding
37 revenue shortfalls due to reductions in federal contributions that support MaineCare
38 programs. The department may use funds in the fund to enhance program outreach and to
39 address changes to federal requirements related to program eligibility and renewals.
40     2. Rulemaking. The department may adopt rules to implement this section. Rules
41 adopted pursuant to this subsection are routine technical rules as defined in Title 5, chapter
42 375, subchapter 2-A.
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1      Sec. 4. Appropriations and allocations. The following appropriations and
2  allocations are made.
3  ADMINISTRATIVE AND FINANCIAL SERVICES, DEPARTMENT OF
4  Miscellaneous Acts and Resolves - Finance 0306
5  Initiative: Appropriates one-time funding to be distributed to the Maine Guaranteed Access
6  Reinsurance Association to increase the reinsurance program for the 2027 coverage year.
7  GENERAL FUND  2025-26  2026-27
8   All Other  $0  $80,000,000
9__________  __________
10  GENERAL FUND TOTAL  $0  $80,000,000
117
12  ADMINISTRATIVE AND FINANCIAL
13  SERVICES, DEPARTMENT OF
14  DEPARTMENT TOTALS  2025-26  2026-27
15
16    GENERAL FUND  $0  $80,000,000
17__________  __________
18  DEPARTMENT TOTAL - ALL FUNDS  $0  $80,000,000
19
12  HEALTH AND HUMAN SERVICES, DEPARTMENT OF
20  Health Care Premium Stabilization Fund N566
21  Initiative: Provides one-time funding for the Health Care Premium Stabilization Fund.
22  GENERAL FUND  2025-26  2026-27
23   All Other  $0  $17,300,000
24__________  __________
25  GENERAL FUND TOTAL  $0  $17,300,000
26
22  MaineCare Federal Response Fund N568
27  Initiative: Provides one-time funding to offset federal cuts to health insurance for certain
28  families and seniors, with $5,000,000 set aside that may be used for technology
29  improvements at the Office for Family Independence and Office of MaineCare Services to
30  implement federal policy changes. The Office for Family Independence may also use these
31  funds to enhance outreach to help with the rollout of new federal requirements related to
32  eligibility and renewals.
33  GENERAL FUND  2025-26  2026-27
34   All Other  $0  $105,000,000
35__________  __________
36  GENERAL FUND TOTAL  $0  $105,000,000
37
33  Rural Hospital Stabilization Fund N567
38  Initiative: Provides one-time funding for grants to rural health care services.
39  GENERAL FUND  2025-26  2026-27
40   All Other  $0  $50,000,000
41__________  __________
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1  GENERAL FUND TOTAL  $0     $50,000,000
21
3  HEALTH AND HUMAN SERVICES,
4  DEPARTMENT OF
5  DEPARTMENT TOTALS  2025-26  2026-27
6
7    GENERAL FUND  $0       $172,300,000
8__________        __________
9  DEPARTMENT TOTAL - ALL FUNDS  $0       $172,300,000
103
11  SECTION TOTALS  2025-26  2026-27
12
13    GENERAL FUND  $0       $252,300,000
14__________        __________
15  SECTION TOTAL - ALL FUNDS  $0       $252,300,000
16
11SUMMARY
17
12      This bill does the following.
181. It establishes the Rural Hospital Stabilization Program to provide grants to defray
19  operating costs for health care providers and health care facilities in rural areas, including
20  start-up costs, incurred in providing inpatient, outpatient, primary, specialty or behavioral
21  health care services to residents of the State and to stabilize the provision of existing health
22  care services when those services are at risk of reduction or elimination.
232. It establishes the Health Care Premium Stabilization Fund to maintain coverage for
24  residents of the State through the Maine Health Insurance Marketplace, Medicaid or other
25  federal assistance programs if the federal Patient Protection and Affordable Care Act is
26  repealed or is administered in a way that reduces access to comprehensive health coverage
27  for residents in the State.
28      3. It establishes the MaineCare Federal Response Fund to supplement funding for the
29  MaineCare program in the event of funding revenue shortfalls due to reductions in federal
30  contributions that support MaineCare programs.
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