New AHCA Secretary Mary Mayhew Passes First Senate Confirmation Hearing — But Not Without Fireworks

Apr 4, 2019

Mary Mayhew, commissioner of the Maine Department of Health and Human Services, right, joined by Gary Alexander, a consultant hired by the LePage administration, appears before the Health and Human Services Committee Tuesday Jan. 14, 2014 in Augusta, Maine.
Credit Joel Page / AP Photo

Governor Ron DeSantis’ pick to head the Agency for Health Care Administration, Mary Mayhew, passed her first Senate confirmation hearing Thursday. Mayhew briefly oversaw Medicaid for the Trump administration, and was over the program in Maine for seven years prior. Some Senators grilled Mayhew on her noted opposition to Medicaid expansion.

Democratic Senator Kevin Rader was aggressive in his line of inquiry during the Appropriations Subcommittee on Health and Human Services meeting.

“Your opposition to expanding Medicaid is well known,” Rader said. “In Maine, when voters passed – through a voter initiative in, I think it was 2016 or 17 – Medicaid expansion through a ballot initiative, you supported the governor’s … determination to prevent this implementation. If Medicaid expansion is on the ballot next year in the State of Florida, or in subsequent years, and voters endorse it and vote for it – would you continue your activism here to prevent that implementation?”

During a tense exchange with Rader, Mayhew at first seemed to deflect.

“First of all, senator, again I had stepped down before that was passed at the ballot, so I was not working in the administration when the governor was protesting the implementation of that law,” Mayhew said. “I am responsible for implementing the laws that are passed – I am here in Maine to serve the governor of the state, to serve the people of the state and to be responsible to the legislature for the implementation of laws.”

But, Mayhew did eventually level with the Boca Raton Democrat about why she has long taken a stance against Medicaid expansion.

“Did I oppose Medicaid expansion in Maine? Yes. Maine expanded long before the Affordable Care Act, and we were hemorrhaging red ink,” Mayhew said.

Another Democratic Senator, Darryl Rouson, asked Mayhew about reports that the agency she now heads is pushing cuts to reimbursement rates for providers who treat children with autism. Rouson noted that he and his wife have a child who is autistic.

“It was brought to my attention that AHCA has proposed up to 54 percent cuts in rates. And it seems to me that that might be just a little bit insensitive at this time,” Rouson said.  

But Mayhew cut the senator’s question short:

“First, Senator, let me say that we no longer going forward, at this time, with those rate changes and rate reductions,” Mayhew said.

Mayhew says following a public information meeting she sat in on last week and reviewing feedback, AHCA made the decision to not move forward with the rate changes “in the last couple days” before the confirmation hearing.

Senator Rader’s line of questioning included Mayhew’s history at the Maine Department of Health and Human Services. He brought up a report from the U.S. Department of Health and Human Services that scrutinized whether a Maine Medicaid waiver program complied with state and federal regulations. The program served beneficiaries with developmental disabilities.

“There were 133 deaths in the OIG report that looked at it, and it found that nine of the 133 deaths were unexplained, suspicious or untimely,” Rader said. “And for another 32 deaths, the state could not provide enough information for the office of the inspector general to make a determination.”

That program was serving about 2,600 beneficiaries in Maine. Rader says Florida’s equivalent program serves tens of thousands.

“Ultimately, the office of inspector general concluded that the state could not show that it had a system to ensure the health, welfare and safety of the 2,640 Medicaid beneficiaries with developmental disabilities covered by the Medicaid waiver,” Rader said. “Did you find there were systematic problems with Maine’s program?”

Mayhew told Raider the report did expose some flaws to the system she formerly oversaw.

“All of the deaths were in fact investigated by the Attorney General’s office. There is a panel in Maine that reviews every death. None of the deaths were as a result of abuse and neglect. It still, however, pointed out that the agency was not timely in investigating,” Mayhew said. “So there were many issues that needed to be addressed.”

Committee feedback on the DeSantis AHCA secretary pick wasn’t all negative. Several senators, like Republican Anitere Flores, commended Mayhew for being accessible.

“You’re the first person in a long time that we give an issue to, and within 24 to 48 hours, our office has a response,” Flores said.

Though the majority-Republican committee pushed Mayhew through on the first confirmation hearing, Senator Raider had some harsh words for the new agency head.

“This is just … this is really one of the worst confirmations of someone that I can imagine in the United States,” Rader said.

Mayhew’s second of three confirmation hearings will take place in the Senate Health Policy committee next week.