Maine budget cuts target Medicaid

PORTLAND, Maine — Tricia Clark will keep her fingers crossed when the Legislature reconvenes this week and takes up a budget plan that calls for sharp cuts in Medicaid and health care spending.

Clark, 19, stands to lose out when the Legislature votes on a plan to slash spending on Medicaid and a slew of other programs ranging from mental health assistance and school grants to dental care, drug abuse treatment and prescription drugs.

Clark is one of nearly 7,000 young adults who will lose Medicaid coverage if the Legislature approves a proposal to eliminate 19- and 20-year-olds from the state’s Medicaid program, which goes by the name MaineCare in Maine.

That’s a tough pill to swallow for Clark, who lives in a studio apartment in Portland, makes a low wage as a kitchen assistant and dishwasher and is still getting on her feet after being homeless for six months last year.

Without Medicaid coverage, she’ll have to cover the costs for her primary care physician and therapist, which she says she can’t afford.

“What’s shocking to me is that medical coverage seems like a bare essential — and I can’t believe they’re taking that away,” she said.

In his effort to cut state spending, Gov. Paul LePage proposed revamping the state’s Medicaid program and eliminating other services and programs administered by the Department of Health and Human Services. Medicaid is a federal program administered by the states that serves as the country’s primary health insurance program for low-income Americans.

Supporters of the cuts say that welfare spending is unsustainable and that Maine provides Medicaid coverage to 35 percent more of the population that the national average. The latest proposed cuts, which must be approved by the full Legislature, will help close an $83 million budget shortfall at the health department.

Last month, the Legislature approved a first round of sharp Medicaid cuts.

Lawmakers froze enrollment in Medicaid for childless adults, meaning that none of the 14,000 or so who now receive benefits will be denied, but that no new enrollees will be allowed. (There’s a waiting list of more than 18,000 for the program.) Legislators also eliminated coverage for parents with incomes between 133 percent and 200 percent of the federal poverty level, casting nearly 12,000 people off coverage.

This week, the Legislature is taking up a budget with additional proposals that, if approved, will cut more people off Medicaid and other health care programs.

Those proposals include eliminating Medicaid coverage for parents with incomes between 100 and 133 percent of the poverty level, as well low-income 19- and 20-year-olds.

LePage’s original proposal also eliminated prescription drug coverage for the elderly and disabled by doing away with the Medicare Saving Program and the Drugs for the Elderly program. The Legislature’s Appropriations Committee, though, approved a plan last week that merely cuts those programs rather than eliminating them altogether.

Other proposals on the table include reducing funding for the state’s Head Start programs; eliminating or reducing funding for dental, vision, chiropractic, occupational therapy, smoking cessation and physical therapy services; and reducing or eliminating Fund for a Healthy Maine programs, which receive Maine’s annual tobacco settlement payments and distribute them for school grants, child care, dental, immunization and other programs.

Opponents of the cuts say not only do the proposals hurt the neediest and most vulnerable residents, but they’re also illegal under federal Medicaid rules.

Rep. Mark Eves, the ranking Democrat on the Health and Human Services Committee, said it’s “completely irresponsible” to move forward with some of the proposals knowing that the Secretary of Health and Human Services Kathleen Sebelius will deny many the cuts. He also doesn’t think Mainers have much of a stomach for taking prescription drugs away from the elderly and the poor.

“I think people inherently understand and sympathize with the need for seniors with disabilities to continue taking their medication,” Eves said.

But supporters of the cuts say tough times call for tough measures. The state will be asking for waivers from the federal government for some of the proposal, said Stefanie Nadeau, the head of MaineCare Services.

In the meantime, Tricia Clark isn’t the only one hoping the Legislature doesn’t approve all the cuts.

Jean Greenleaf, 73, of Winthrop, originally stood to lose funding for the drugs she takes for diabetes, cholesterol, a stomach disorder and depression under LePage’s original budget proposal. It appears her prescription drug coverage will be saved under the Appropriations Committee’s compromise, but she’s likely to lose coverage for hospital visits, which would expose her to more than $1,200 in payments that are now covered.

That’s a lot of money for Greenleaf, a widow who brings in $1,175 a month in Social Security and another $150 to $200 a month from office cleaning jobs. There’s little money left over after she pays $400 a month on the mortgage of her Winthrop home, electricity, phone, food and, in the cold-weather months, oil for heat.

“I think it’s kind of cruel to do this to the elderly, especially those who can’t work,” said Greenleaf. “I’ve been worried to death about my pills. And there are a lot of people a lot worse off than I am.”