We’re not sure what Gov. Paul LePage has against babies, women or taxpayers, but those are the people devastated most by his veto of a bill that would have provided the state’s poorest with health care coverage for birth control and other family planning services. There was no excuse for him to include LD 1247 in his recent veto rampage and no excuse for the Legislature’s failure Thursday to countermand his order.
Maine women earning up to $23,340 annually already qualify for publicly funded health care if they become pregnant. But those same women are not eligible for Medicaid coverage for the cheaper expense: birth control. LD 1247 would have changed that, allowing women who earn up to 200 percent of the federal poverty level to get health care coverage for preventive services such as birth control, in addition to cancer screenings, well-woman exams, and testing and treatment for sexually transmitted diseases.
If the Legislature wanted to reduce the financial costs borne by the public for unintended pregnancies, and if it wanted to avoid the long-lasting societal consequences of having women abort or raise children they don’t intend to have, it should have passed LD 1247 over LePage’s objections. Lawmakers failed to reach the two-thirds majority needed to override the veto. The House needed 97 yeas and got 92, with six members absent. Several moderate Republicans switched their votes.
Family planning is so successful it has an enhanced federal match rate to give states incentive to cover the basic service: For every $1 in state funding, the federal government provides $9. For a relatively small investment in the short term, Maine could have saved more over the long term — and avoided much heartache. The state’s nonpartisan Office of Fiscal and Program Review estimated the bill ultimately would save $1.67 million to $2.76 million per year.
LePage ignored the independent analysis, however. In his veto letter, he said people earning between 100 and 200 percent of the poverty level could get subsidized private health care coverage under the Affordable Care Act, and — in his words — “individuals who intend to make” less than the poverty level could take advantage of the sliding fee scale at clinics. Both options, by the way, are funded with tax dollars. (And who intends to live in poverty?)
But LePage’s suggestions are not based in research. Maine should want to give people incentive to access preventive care by keeping costs for patients low. Otherwise, they won’t use the services. What might appear to save money actually costs the state more in the long run.
For example, one study in the St. Louis region enrolled 9,256 adolescents and women at risk for unintended pregnancy and offered them contraception at no cost between 2007 and 2011. The researchers saw a significant reduction in unintended pregnancies, with abortion rates among the selected group less than half the regional and national rates.
“Research over the last four decades has consistently concluded that the imposition of cost sharing on low-income and vulnerable populations reduces both necessary and unnecessary care and correlates with increased risk of poor health outcomes,” according to research by the National Health Law Program.
“It’s very clear that this is a service that researchers found to be very effective, and for people who are very low income, even a small amount can be a barrier to care. Preventing unintended pregnancy in our society has value; it has a financial value, and it also has a societal value,” summed up Alina Salganicoff, vice president and director of women’s health policy at the Kaiser Family Foundation.
LePage and a minority of lawmakers failed to do their part to improve lives and save tax dollars. They should be ashamed.