May 24, 2018
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Baby survives, problems remain

Pat Wellenbach | AP
Pat Wellenbach | AP
Maine Reps. David Webster, D-Freeport, and Margaret Rotundo, D-Lewiston, pour over documents during a work session at the legislature's Appropriations Committee at the State House in Augusta, Maine, on Monday, June 6, 2011.

Mainers from all economic classes should be grateful to the legislators who toiled for untold hours and summoned a spirit of public service and compromise for a greater good to reach a deal on the Health and Human Services budget.

There’s no telling how Gov. Paul LePage will respond; if he is wise, he will thank legislators for their work. If he is convinced that structural problems remain in the department’s budget, he must work to explain them to legislators and the public and craft a plan to fix them.

He is too prone to falling back into ideological mode, railing about the cost of the too-generous “welfare” programs. The MaineCare programs that were at the heart of the budget shortfall are, in fact, federally funded, state-matched health insurances.

Here’s a truth that should not be up for debate: The more people covered by health insurance, the lower the collective cost of care. Uninsured people wait too long to see health care practitioners when they are ill, do not learn about preventive care and health maintenance through regular well-visits, and when they do fall ill, they often get costly care at hospital emergency departments or find themselves with far more serious problems than if they had sought attention earlier.

If Americans could reach a consensus on how to pay for a national health care plan — essentially, extending Medicare to all — and see past the fear-mongering about socialism from opponents, many of these problems would disappear.

But that’s a debate for another time and place.

In Augusta now, there were and are decisions that need to be made about the level of care the state can afford to provide. Reasonable people can argue reasonably about where to draw the line on such spending, and members of the Appropriations Committee have done just that.

The budget compromise rolls back eligibility for adults with children from 200 percent of the federal poverty level to 133 percent. The higher threshold was established over 10 years ago, when state coffers were flush with cash. The compromise also caps spending through June 30 for childless adults at $40 million. To achieve that, no new enrollments will be allowed. People are expected to fall off the rolls, as many as 500 a month, as their income improves or they die. Services are likely to be managed with an eye to frugality.

Democrats were reluctant to push the childless adults, known in DHHS parlance as noncategoricals, off the health care rolls. Though the governor portrays them as able-bodied and young, many face serious health challenges such as diabetes and cancer.

Democrats also believe the governor created the budget problem by underfunding the department. Many top-level DHHS officials who knew how to manage the complex federal-state programs were fired, Democrats say, leaving neophytes in charge.

The minority party ought not to dwell on such recriminations and instead focus on being players in the debate that will ensue next year, when an $80 million gap looms. The tax cuts Gov. LePage and Republican legislative leaders touted must be reconsidered if revenues do not rebound in the coming months. Democrats can spur this discussion.

Legislative Republicans deserve praise for tuning out their governor and working toward a compromise. They walked a difficult political path, but one that represents true leadership and service.

The governor will rail about gimmicks and half-measures, but the compromise represents a balance between necessary frugality and appropriate compassion. The governor has the opportunity to play Solomon; he can threaten to cut the baby in half but stop short of doing so, or he can swing his axe and kill the compromise. There’s only one right move.

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