September 23, 2018
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Yes on Question 2: Medicaid expansion will benefit Maine in many ways

Mario Moretto | BDN
Mario Moretto | BDN
Andrew MacLean, deputy executive vice president of the Maine Medical Association, voices his organization's support for Medicaid expansion in 2014.

Updated:

Do you want Maine to expand Medicaid to provide healthcare coverage for qualified adults under age 65 with incomes at or below 138% of the federal poverty level, which in 2017 means $16,643 for a single person and $22,412 for a family of two?

“According to a recent assessment of Ohioans who gained coverage through Medicaid expansion, a majority now find it easier to find or keep a job, manage their health to avoid costly trips to the hospital down the road, and even find it easier to put food on the table.”

“You must ensure that individuals, families, children, aged, blind, disabled and mentally ill are not suddenly left without the care they need to live healthy, productive lives.”

These endorsements of Medicaid expansion aren’t from liberal activists or paid spokespeople. They are from Republican governors.

The first comes from a Time column written by Ohio Gov. John Kasich in support of expansion, which he notes extended health care coverage to veterans and those with mental illness and addiction, among others.

The second is part of the argument from Nevada Gov. Brian Sandoval as he worked to persuade lawmakers not to end the expansion as part of a failed repeal of the Affordable Care Act.

Governors in 31 states have said yes to Medicaid expansion, under which the federal government pays at least 90 percent of the cost of expanding the public health insurance to low-income people who aren’t poor enough or don’t have a disability to otherwise qualify for Medicaid. They include then-Indiana Gov. Mike Pence, who is now vice president.

These governors would not have expanded Medicaid — and continued to support expansion — if it caused state budget crises, tax increases, hospital debt or reduced care for the elderly and disabled, all false claims made by Maine expansion opponents.

In Maine, the Legislature has approved Medicaid expansion five times. Gov. Paul LePage has vetoed it five times.

Now, Maine voters have a chance to overcome LePage’s intransigence to join the states that have expanded the reach of health insurance to people who, although they are working hard, can’t afford it.

A “yes” vote on Question 2 will bring many benefits.

The first, of course, is that more Maine people — about 80,000 more — will have health insurance, allowing them to access preventative care, vaccinations, addiction treatment, counseling and other needed care. Currently, many people without insurance put off doctor’s visits until illnesses or injuries become so bad they threaten their work and wellbeing. When they do seek care, it is more expensive. The cost of that expensive care is borne by hospitals and those with insurance as rates are raised to cover the cost of caring for the uninsured. In fact, a recent analysis found that private insurance premiums were about 7 percent lower in states that had expanded Medicaid compared to those that had not.

Medicaid expansion will also put Maine hospitals on more secure financial footing by reducing their uncompensated care and expanding their patient base. In many rural communities, hospitals are the largest employers.

It will also help the state’s economy as billions of federal dollars flow into the state, creating 6,000 new jobs, according to a report by Elizabeth Kilbreth, of the Muskie School of Public Service.

Opponents of Medicaid expansion say it is too costly for Maine. This isn’t true. If Maine expands its Medicaid coverage, it would cost the state $55 million in fiscal year 2021, the first year of full implementation, according to the Maine Office of Fiscal and Program Review. That year, Maine will receive $525 million from the federal government to fund the expansion. The $55 million figure represents 1.5 percent of a single year of state spending.

Simple math shows the benefits to Maine far outweigh the costs by nearly 10-to-1.

There is also no evidence from other states that Medicaid expansion caused states to reduce care for the elderly, cut school funding or do any of the other scary things opponents say will happen if Question 2 passes in Maine.

There is a reason that 17 Republican governors fought to maintain Medicaid expansion and that groups such as the Maine Hospital Association and Maine Medical Association are advocating for expansion here. It works.

Maine has left billions of federal dollars on the table and left tens of thousands of its residents without health insurance by rejecting Medicaid expansion.

A “yes” vote on Question 2 will begin to right that wrong.

 


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