Maine health clinics say state failed to pay nearly $6.5M cost-of-living increase
Maine’s network of community health clinics is confronting a $6.5 million funding gap after the state health department declined to issue cost‑of‑living adjustments that were scheduled for July. The clinics, which operate as federally qualified health centers, had budgeted for a 2.5 percent rate increase that would have distributed roughly $6.5 million across 20 facilities.
Lindsay Hammes, a spokesperson for the Maine Department of Health and Human Services, said the 2026 supplemental budget included inflation increases for many Medicaid services, but the Legislature did not appropriate specific funds for the community health centers’ COLA. “The department cannot implement COLAs for which there is no funding that has been appropriated by the Legislature,” Hammes wrote in an email. “We are required to submit a balanced budget and Maine DHHS can only spend the dollars that have been appropriated.”
The decision has left clinics scrambling to maintain services for more than 210,000 patients in rural and underserved areas, many of whom rely on low‑income coverage. Bryan Wyatt, a spokesperson for the Maine Primary Care Association, noted that without the adjustment, centers will struggle to keep up with rising operational costs. “It’s not realistic for our health centers to provide comprehensive and high‑quality services without a reliable, predictable adjustment,” Wyatt said. “We have to pay staff more, the cost of care keeps going up, and the COLAs help address that.”
Penobscot Community Health Care in Bangor, the state’s largest federally qualified health center, is among the hardest hit. The clinic needs $3 million within the next two months to avoid bankruptcy, and it should have received $975,000 from the COLA, according to Wyatt.
Community Clinical Solutions in Lewiston, which meets the criteria for a federally qualified health center but does not receive a federal grant, is also feeling the strain. CEO Coleen Elias said the clinic’s patients are predominantly Medicaid beneficiaries, and the missing $157,000 in expected COLA funds will prevent equipment upgrades and delay hiring. “We’re so lean that there’s nothing left for us to cut,” Elias said. She later added, “How is that fair to put that onus back on us? We have to spend all this time appealing to foundations, appealing to the public, to continue to fill gaps that are created by policy decisions.”
State Representative Jack Ducharme, the ranking Republican on the appropriations committee, has urged the department to reconsider. He argued that LD 1787 established the COLA as an automatic adjustment tied to a federal inflation index, not contingent on a separate appropriation. In a letter sent Aug. 16 to Molly Bogart, deputy commissioner of DHHS, Ducharme wrote, “This raises a significant question about whether the department’s position is consistent with legislative intent,” and described the clinics as “a critical last line of defense for health care access in many rural areas.”
Hammes countered that the Legislature used the same index to raise reimbursement rates for community clinics by 4.7 percent in 2024 and approved a 1 percent increase in 2025, but this year no funding was provided. She noted that total MaineCare spending on community health centers has risen nearly 50 percent since early 2023, largely because of those rate increases.
Ducharme suggested the department could draw from the MaineCare Stabilization Fund, which holds more than $30 million, to cover the COLA shortfall. “They can do it,” Ducharme said. “All they’ve got to do is send us a letter saying: ‘We’re doing it.’”
Clinic leaders, however, argue that relying on ad‑hoc solutions diverts attention from patient care. “We have to spend all this time appealing to foundations, appealing to the public, to continue to fill gaps that are created by policy decisions,” Elias said. As the funding gap persists, health centers across Maine are exploring emergency measures to keep their doors open while continuing to serve vulnerable populations.
