December 16, 2017
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What LePage got wrong when he said Collins and King are ‘dangerous’

By Tom Saviello, Special to the BDN
Updated:
George Danby | BDN
George Danby | BDN

U.S. Sens. Susan Collins and Angus King are political heroes for their strong stands to protect the health care of millions of Americans, including tens of thousands of people in Maine. Unfortunately, Gov. Paul LePage sees it differently.

Instead of constructively adding to the health care debate and working to find solutions to hold down insurance premiums and increase access to health care, he has resorted to personal attacks.

LePage even went so far as to call Maine’s two senators “dangerous,” and further criticized former Senate Majority Leader George Mitchell, a man of unquestionable integrity, when he defended their votes against the Senate’s “skinny” repeal of the Affordable Care Act.

The governor’s criticism of Medicaid expansion in the Wall Street Journal is unfounded and is not supported by the facts of what has happened in Maine.

Maine did expand Medicaid coverage to low-income individuals in early 2000. Yes, it was expensive. What the governor did not tell you was why.

Maine, like the rest of the nation, was in a health care crisis. Health care costs were rapidly increasing and charitable medical costs were skyrocketing. Those of us with health insurance were picking up this cost through increases in premiums. Something needed to be done.

When MaineCare, the state’s Medicaid program, was expanded, we saw the uninsured rate in the state decline. We also saw that access to preventive care increased, particularly for people ages 45 to 64, and the overall quality of care improved.

The cost of expanding coverage was more than expected, just as was the case for health care costs in general for the entire United States.

The reasons are straightforward: Sick people could finally get medical care they needed; hospital reimbursements were not properly assessed; there was no effort to manage the newly covered individuals; and the financial shock of the Sept. 11 terrorist attacks hit state finances hard.

The Affordable Care Act, with its expansion of Medicaid, gave states, including Maine, the opportunity to help many of the same low-income individuals.

Most of the money needed to fund the initial program would come from fees on the rich, certain cuts in Medicaid reimbursements and assessments on certain medical devices. States that expanded would receive 100 percent funding for newly eligible people initially and no less than 90 percent in federal funding over time. That’s a great deal for the 31 states that expanded their Medicaid programs.

LePage, regrettably, vetoed this expansion as proposed with LD 1578 in 2013. So a new bipartisan plan — LD 1487 — was created the following year by Maine legislators based on Republican principles around “managed care.”

It would have reduced costs by emphasizing preventive care and instilled more personal responsibility into the system. The bill proposed to adopt managed care in an effort to control costs under Medicaid expansion.

The governor’s response: Veto.

So we tried again by melding Republican state expansion plans from Indiana, Kentucky and Arkansas.

The bill — LD 633 — would have allowed individuals with income equal to or below 100 percent of the poverty line to receive coverage through the Medicaid.

It would have authorized the state to seek approval to provide individuals with income levels over 100 percent to 133 percent of the federal poverty line coverage from a private health insurance plan or other mechanisms.

It would have provided incentives for adopting healthy behaviors. It, too, emphasized preventive care and personal responsibility.

It gave the Legislature the ability to act if federal funding for the Affordable Care Act was reduced or eliminated. It required the state to review and verify any savings and revenues generated by health care expansion.

The federal government would have pumped nearly $1.2 billion into Maine — a 10 to one match for what was necessary to be spent by the state. This money would ripple through the state’s economy in the form of increased employment in the health care sector, as well as savings on private insurance premiums and, more importantly, healthier Maine residents.

LePage also recently claimed during a radio interview that the number of uninsured in Maine has steadily decreased under his administration. He has the Affordable Care Act to thank, given that more than 70,000 Mainers now have coverage through the marketplace the law created. Tens of thousands more Mainers with low income would have had health insurance if the expansion bills had been successful.

King, Collins and Mitchell are not “dangerous.”

They are heroes for looking out first for the residents of Maine and the nation. They recognize there are parts of the Affordable Care Act that are working, but also there are problems with the law and with how one party constructed it. They want to fix it, but together, with all political parties involved. They want to do it the right way.

Tom Saviello is serving his fourth term in the Maine Senate. He is the Senate chair of the Environment and Natural Resources Committee and also serves on the Agriculture, Conservation and Forestry Committee.

 

Correction: An earlier of version of this incorrectly stated Gov. Paul LePage vetoed LD 633. It died in the Maine Senate.


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