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Honoring Maine veterans with health care

Posted Nov. 10, 2013, at 2:36 p.m.

On Veterans Day, we will recognize and thank all the men and women who have served us in the military during times of war and peace. With an estimated 130,000 veterans living in Maine, including about 10,700 female veterans, our state has many to thank. While we should honor our veterans every day, we have a real opportunity to recognize people who have served our country and ensure that those who have low incomes and aren’t eligible for comprehensive health care services through the Department of Veterans Affairs have access to the health care they need and deserve.

Nearly 3,000 veterans would likely benefit from a decision by our state to accept the federal funds that have been set aside for Maine to cover people with low incomes.

There are about 1.3 million uninsured veterans in the U.S. A study by the Urban Institute estimates that about 535,000 uninsured veterans are eligible for coverage under Medicaid expansion, but that eligibility remains contingent on the decision of each state to accept the federal funds that would pay for the expansion.

The Affordable Care Act provides funding for each state to extend their Medicaid programs (MaineCare in Maine) to cover people up to 138 percent of poverty (about $15,415 for an individual). The federal government will pay 100 percent of the cost of health care services for those newly eligible under Medicaid expansion for the first three years. The funding slowly decreases, but to no less than 90 percent over time.

The Urban Institute study estimates that expansion in Maine would benefit about 2,700 low-income veterans and another 1,000 spouses of veterans. Nearly 2,300 of those who would be eligible live below the federal poverty level (about $11,490), which means they won’t qualify for subsidies in the marketplace.

It’s often assumed veterans get the health care they need, when they need it. Unfortunately, that’s not always the case. While veterans often have chronic health care needs, access to health care services through the Veterans Administration is limited, based on active duty status, length of service, income and service-related disability. While the VA plays a critical role in providing health care to many, its services are not typically available to family members.

Coverage under Medicaid expansion would provide access to medically necessary services for veterans who have limited income and their family members. It would provide access to preventive services and treatment for chronic illness. It would improve the continuity of care for those in need of services, especially those who live in rural areas of the state who do not live close to a VA medical facility.

An analysis by the National Health Law Program of the Department of Veteran Affairs priority data indicates that for some veterans, expanding Medicaid automatically improves their standing in the VA’s priority system. If a state expands, many veterans will automatically have improved access to health care through the VA.

We know there are too many Mainers who are one accident or illness away from financial disaster or hardship. We also know it doesn’t have to be this way.

The benefits of expanding MaineCare are clear — coverage for 69,500 people, most of whom are working low-wage jobs; $250 million in federal funds brought to the state that would generate millions more in economic activity; and the creation of more than 3,100 jobs.

Expanding MaineCare will help decrease the growth in charity care provided to the uninsured and help to slow the increase in private health insurance premiums. Expansion would also provide badly needed revenues to support Maine’s health care infrastructure including our doctors, hospitals and health clinics.

Let’s be clear to veterans living in Maine: Not only do we honor them on Nov. 11, but we also thank them for preserving our freedom and safety into the future. Let’s recognize our veterans for the sacrifices they have made on our behalf and make sure they have access to the comprehensive and affordable health care they need and deserve.

Nelson Durgin, chairman of the Bangor City Council, is a former adjutant general of Maine and has extensive experience in health care and human services.

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