June 21, 2018
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Medicaid expansion remains reasonable, right despite defeat by minority

Linda Coan O'Kresik | BDN
Linda Coan O'Kresik | BDN
Zachary Field juggles a variety of items during a skit portraying a regular guy who is juggling life's responsibilities when his mom breaks a hip. The skit, which was presented by the Brewer non-profit Food AND Medicine, represented the stresses that many families face when a loved one needs intensive care in the home and also the need for more support for the workers giving the care. The gathering at Pierce Park in Bangor celebrated care giving on May 9, 2013 where the group called on Maine Senators to create a comprehensive solution to the growing long-term care needs of patients and their families.


There are reasonable women and men left in the Maine House and Senate, apparently just not enough. In a destructive decision for Maine on Wednesday night, the House fell a few votes short of the two-thirds support needed to override Gov. Paul LePage’s veto of legislation that would have expanded Medicaid.

Expanding health insurance under the Affordable Care Act to some of Maine’s poorest residents was the reasonable thing to do. It was reasonable economically, with one nonpartisan report from the Kaiser Family Foundation estimating Maine would spend $570 million, or 3.8 percent, less on the state’s Medicaid program if it expanded access, while the federal share would increase $3.1 billion, or 11.4 percent. The foundation also predicted the influx of money would boost jobs and economic activity.

It was reasonable politically. The legislation to cover about 50,000 adults without children making $20,628 for a two-person household, and prevent about 25,000 parents and childless adults from losing their Medicaid coverage next year, had support from Democrats, Republicans and independents. A poll by the Maine People’s Resource Center showed 58.1 percent of respondents definitely support expansion, mirroring national support levels.

Medicaid expansion was a reasonable move to improve people’s health and even save lives. Research shows that the uninsured are less likely to seek preventive care, such as prostate screenings or pap smears, increasing the likelihood of preventable diseases. The ill health of the uninsured affects everyone. They still seek medical help, often when a condition has worsened and become more expensive to treat, and hospitals must provide care. The cost is passed on to those who hold insurance.

Medicaid expansion was reasonable because it would have evened out the continuum of health insurance assistance. Without it, there will be a major coverage gap. Maine people with incomes near and below poverty will not be eligible for subsidies to buy insurance through the new health insurance exchange when it opens this fall. That means the very poorest will not receive help to pay for insurance, while those who earn more will receive assistance.

Medicaid expansion was not only reasonable but right. Without it, tens of thousands of Maine residents will continue to put off checkups, be forced to pay out of pocket for emergency care or pass on costs to hospitals and premium holders, or go without prescription medication. Insurance should be there when people need it, no matter how much they earn. Everyone gets sick.

We are proud of the handful of Republican representatives who voted to override, including Don Marean of Hollis, Carol McElwee of Caribou, Tom Tyler of Windham, Corey Wilson of Augusta and Ellen Winchenbach of Waldoboro. We are glad that a large majority of House members support expansion.

But the minority’s distortion overshadowed the majority’s sensibility. They twisted the issue and made it into a debate about whether the federal government can be trusted to pay 100 percent of the costs for three years, before it drops down to 90 percent thereafter — even though it has never wavered from its promised Medicaid funding rates.

Now Maine certainly won’t get the benefit of more than $3 billion in additional federal funds. One of the most significant initiatives of this legislative session was defeated by a few who acted unreasonably and were simply wrong.

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