Medicare and Medicaid are the dual foundations of the health care system in the United States and Maine.
These two programs work together to help protect the health and welfare of hundreds of thousands of Maine parents, grandparents and children.
Medicare, which is federally funded, is the better known of the two. It provides health insurance to senior citizens and people with disabilities. It includes coverage for hospitalization, medicine, doctor visits and other health care services.
Medicaid, which relies on federal and state funding, provides the same sorts of services to low-income families and children as well as vital assistance to seniors and people with disabilities.
Medicaid covers the cost for 70 percent of Maine seniors who live in long-term care facilities. The program also provides critical services that help Maine seniors and people with disabilities live independently, and has helped Maine to have one of the lowest uninsured rates for children in the country.
Earlier this year, the U.S. House of Representatives passed a budget plan that would radically undermine Medicaid, making significant cuts in funding for the program.
Proposals under consideration include making Medicaid a block grant program, which would end the successful partnership between the federal and state government on Medicaid; and global spending caps, which would cut spending arbitrarily on health care programs without concern for the effects.
These changes won’t do anything to reduce the cost of health care, to make people healthier or to improve the quality of care people receive. Instead, they simply would shift costs from the federal government onto state and local governments.
Sens. Olympia Snowe and Susan Collins and Reps. Mike Michaud and Chellie Pingree have worked hard to resist efforts to strangle the health care safety net. But as efforts move forward to reduce federal spending, they will need a lot of support in their efforts to defend the poor, people with disabilities, the young and the elderly.
If the federal government makes deep cuts in funding for Medicaid, states will have few choices.
They can make children, seniors, families and people with disabilities uninsured — raising everyone’s insurance premiums when the uninsured are forced to seek expensive emergency room care.
They can cut payments to doctors’ offices, hospitals and nursing homes — putting both access and jobs at risk.
Or they can cover the difference by raising our taxes or cutting other critical services such as schools and police.
All of these options would be bad for Maine’s economy, Maine’s health care providers and most importantly Maine’s most vulnerable populations who rely upon Medicaid to provide them with access to necessary health care services.
As Congress and the president work to balance the budget and reduce our country’s debt, it’s important that they make their decisions on the facts.
Block grants and spending caps reduce costs by covering fewer people, and by taking access to health care away from thousands. They don’t help control health care inflation. They won’t reduce private insurance premiums. And they won’t lead to better health outcomes.
There are better ways to control health care costs than simply denying people care.
The Affordable Care Act, for example, rewards doctors for reducing costs by coordinating care. It also encourages policies to keep seniors and people with disabilities in their homes, where they want to be, and out of long-term care facilities.
The act also invests in more primary care physicians, who can help people stay healthier and reduce more expensive treatments in the future. And the act cracks down on Medicaid fraud, improving policing and enforcement against provider and drug company overcharges.
More can be done.
To start, we should expand efforts to prevent costly medical errors and hospital-acquired infections. We should take measures to bring down the cost of prescription drugs, including stopping pharmaceutical companies from keeping more cost-effective generic medicines off the market.
Ideas like these not only reduce the cost of Medicaid, they also drive down the overall cost of health care for everyone. And they do it by improving care.
That’s good for families, the budget and for the economy.
Sara Gagne-Holmes is executive director of Maine Equal Justice Partners, a statewide, nonprofit civil legal aid organization.