January 24, 2018
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DHHS’ cruel shame-and-blame game against the poor and needy

By Tania Tonos and Cait Vaughan, Special to the BDN
Stock photo | BDN
Stock photo | BDN
The Maine Department Health and Human Services has asked the federal government to let it make changes to the state's Medicaid program, many of which could be harmful to Maine's most vulnerable.

The Maine Department of Health and Human Services continues its war on the poor. This summer, DHHS submitted an application to the Centers for Medicare and Medicaid Services that — if approved — would make harmful changes to the state’s Medicaid program, known as MaineCare.

If approved, people who receive MaineCare could be subject to mandatory premiums, copays for “inappropriate use” of the emergency department, work and volunteer requirements, and more. We anticipate that the Centers for Medicare and Medicaid Services will approve the application any day now, resulting in more red tape and surveillance over MaineCare recipients, as well as people losing their care.

The application claims to want to save resources for “the neediest populations in our state,” yet does not explicitly name those experiencing homelessness. While the end of poverty begins with affordable housing, it also helps to not force people to pay money they do not have for quality health care.

DHHS claims that MaineCare eligibility rules “can serve as a deterrent to work,” but there is no sound proof that limiting eligibility will increase employment. The reality is that the homeless experience stigma and discrimination in hiring practices, with employers often reluctant to hire someone once it is discovered that he or she is sleeping in a shelter.

This waiver application also seeks to end retroactive coverage, a benefit that currently allows for someone’s MaineCare eligibility to date back three months prior to the month of application, if the person had incurred prior medical bills and was otherwise eligible during that period. Eliminating this option means homeless patients in the midst of a health care crisis will be worrying not only over a MaineCare application, but also the unaffordable costs of necessary care.

Already, people who are homeless say they experience long waits in the ER while in pain, unseen for hours, before often being told to leave the premises. Many of the homeless are often unable to obtain necessary health care services such as operations, medicine and follow-up care because they have no insurance or the wrong kind. These are real experiences that rarely receive public attention.

There will no doubt be legal challenges to the particulars of the waiver if it is approved. It’s also important to address the underlying spirit of this attack. DHHS views MaineCare as welfare and welfare as bad because, according to them, a significant amount of people do not deserve the assistance. Therefore, cuts to Medicaid are in the best interest of “honest, hardworking” taxpayers who are being robbed by lazy people only pretending to be poor.

DHHS claims they want to save money and focus on the “most needy,” but the result will be denying poor Mainers their right to survive, while increasing administrative costs to ensure adherence to new requirements. The shame-and-blame game against the homeless and poor is a waste of Mainers’ time and money, and it is cruel.

It is time for DHHS to be held accountable. Organizers and advocates need to take aim at classism, ableism and racism — the pervasive social ills in which such political maneuvers often are rooted. What if we viewed poverty for what it is — systemic violence and abuse — instead of a character flaw of individuals? What if we created conditions wherein people experiencing poverty and homelessness could drive solutions to problems, instead of an institution of bureaucrats deciding they know what is best for poor people?

Tania Tonos is a member of Homeless Voices for Justice in Portland. Cait Vaughan is a community organizer for Maine Family Planning in Augusta.

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