For the past 6½ years, Gov. Paul LePage and his administration have steadily chipped away at Maine’s ability to protect the health of the state’s residents.
The assault on Maine’s health has come from all directions.
There was the end of Medicaid coverage for anti-smoking medications early in the governor’s tenure. There was the elimination of Medicaid health coverage for low-income parents and adults without children that took effect later on. And, of course, there has been LePage’s refusal to accept a predominantly federally funded expansion of Medicaid that has allowed other states to post double-digit drops in the rates of their populations lacking health insurance.
But the health of Maine’s population isn’t determined only by health insurance coverage and medical care.
During the LePage administration, thousands of people who need access to food assistance so they don’t go hungry, and thousands of others — including nearly 15,000 children — who need small amounts of financial assistance so they can afford rent and basic necessities have lost the little assistance they had.
It’s difficult for someone to stay healthy without enough food, and financial stress and poverty can be toxic to one’s health as well. The fact that food insecurity in Maine has been on the rise, as well as the proportion of Maine children growing up in extreme poverty, doesn’t bode well for Maine’s health.
And then, there’s been the utter disinvestment in the state’s ability to respond to public health crises such as the spread of infectious diseases, and to proactively tackle health challenges such as tobacco use, opioid addiction, obesity and more.
Although lawmakers have maintained funding for it, the LePage administration has unilaterally dismantled the state’s public health nursing program. Public health nurses are the state health workers who have traditionally been in charge of minimizing the spread of tuberculosis, and today there are barely enough of them to carry on that basic responsibility. And at a time when about 1,000 drug-affected babies are born each year, drastically fewer public health nurses are available to provide needed follow-up visits at home.
The latest blow is $10 million in cuts over the next two years to state public health budgets. This money, which will instead be used to reduce the amount of taxpayer money needed to fund Medicaid, paid for public health promotion and prevention efforts at the local level, which had already taken a hit last year. And it paid for student health centers in schools across the state.
Without this small amount of funding, there are few resources available to help communities across the state to proactively tackle health challenges that are unique to them. There’s little funding to help the health care providers, law enforcement agencies, schools and others in those communities to coordinate local responses to public health emergencies — such as the bath salts epidemic several years ago or the 2009 outbreak of H1N1 influenza.
Maine’s public health infrastructure has always been more tenuous than in most other states. Most states can rely on county-level public health departments. But Maine has loose coalitions of health care providers, schools, local governments, law enforcement agencies and others to stand in and make sure the public’s health in their local areas is protected.
Maine has only had these loose coalitions for the past decade. Now, over the course of two years, the LePage administration has eliminated all of their direct state funding.
Because of these cutbacks, it should surprise no one that Maine is failing to combat the opioid epidemic that’s claiming more than a life per day. It should surprise no one that the portion of Maine’s non-elderly population without health insurance now exceeds the national average. It should surprise no one that Maine posted the largest, one-year decline of any state in the United Health Foundation’s annual America’s Health Rankings report released last year.
And it should surprise no one the next time Maine proves it’s unprepared to handle the next infectious disease outbreak.