By Joe Lawlor

The U.S. Supreme Court on Monday refused to hear a case pitting Maine Gov. Paul LePage against the federal government that could have resulted in thousands of low-income young adults losing their health care coverage.

If LePage's legal challenge had been successful, about 6,500 19- and 20-year-olds would have been kicked off the Medicaid rolls.

The justices' rejection of the case means the LePage administration must adhere to a lower court's ruling to continue providing health coverage to the young adults until at least 2019. Removing the 6,500 from Medicaid would have violated the Affordable Care Act, according to previous court rulings.

The case not only pitted the LePage administration against the federal government, but also the governor against Maine's Democratic attorney general, Janet Mills.

Mills has repeatedly said that the case was not likely to be successful, and was a waste of time and money, and she reiterated that view on Monday.

"There was no reason for the U.S. Supreme Court to take this case," Mills said in a statement. "I respect the earnestness with which the governor sought to advance his argument, but I have felt all along that it lacked legal merit. As an independent constitutional officer, I take seriously my duty to offer unvarnished legal advice and to uphold the rule of law, and I will continue to do so."

LePage hired a private attorney and as of January had spent $53,000 on legal fees, according to documents obtained by The Associated Press through the Freedom of Access Act. The Press Herald on Monday requested updated figures.

LePage's office didn't have an immediate response early Monday afternoon, but Mary Mayhew, Maine's health and human services commissioner, pointed to the administration's longstanding view that MaineCare needed to be reformed.

"Although I am deeply disappointed by the Supreme Court's decision, we will continue to work tirelessly to reform Maine's Medicaid program to prioritize our elderly and severely disabled neighbors instead of able-bodied young adults."

The administration has previously estimated that providing MaineCare coverage to the 19- and 20-year-olds costs about $10.6 million a year. The federal government pays roughly $6.6 million of that, and the state about $4 million. However, most of the LePage administration's cuts to MaineCare -- the state's name for Medicaid -- were approved since he took office in 2011, and Maine has significantly reduced the number of people on the program -- from 350,000 to less than 300,000 -- by tightening eligibility requirements.

Mayhew has argued that trimming the number of people on MaineCare has allowed the state to reduce waiting lists and better serve those who are on the MaineCare program.

The administration has also rejected efforts by Democrats to expand MaineCare under the Affordable Care Act, despite the federal government being willing to pay for most of the expansion costs. Another effort to expand MaineCare -- sure to attract a veto by LePage -- is currently being contemplated by the Legislature.

Rep. Drew Gattine, D-Westbrook and chair of the health and human services committee, said Monday he continue to be perplexed by LePage's stance fighting against the program.

"I think it indicates a lack of concern in providing health care to low-income folks," Gattine said. "Why are we putting so much effort into limiting the ability of people to see a doctor and get the medicine that they might need to be successful?"

The Republican governor appealed to the Supreme Court in February after the 1st U.S. Circuit Court of Appeals ruled that rolling back coverage for that age group was illegal because President Barack Obama's health care law prohibits states from reducing coverage levels for children until 2019. Maine has covered 19- and 20-year-olds -- who are considered children in the Medicaid program -- for more than two decades.

LePage sought to eliminate coverage for young adults who earn less than about $1,500 a month for those who live with their parents, or $2,600 a month for those to live alone.

In urging the justices to hear the case, the LePage administration said that the federal government can't force Maine to keep the young adults on the rolls because the court has previously ruled that states can't be forced to expand their Medicaid programs.

But federal officials said there was no need for the justices to weigh in because there was no disagreement between the lower courts to be resolved and no other states have joined Maine's challenge to the requirement. They noted that "even Maine's own attorney general has disavowed" the state's challenge.

(c)2015 the Portland Press Herald (Portland, Maine)