Gov. Paul LePage and Republican state lawmakers who voted to remove nearly 30,000 people from Medicaid need a waiver from the federal government to make many of these cuts. The debate over the waiver may sound like inside bureaucratic wrangling, but the consequences will have a real and devastating impact on thousands of Maine seniors, people with disabilities and working families.

A recent column by state Rep. Richard Malaby, R-Hancock, “Which Medicaid waiver do you object to?” (BDN, Sept. 11), argues that the state needs to make these cuts so we can help the “truly needy.” But this rhetoric does not match reality. The thousands of people they would like to take health care away from are truly needy. They include working parents, who are trying to make ends meet.

They include 19- and 20-year-olds with serious illnesses such as diabetes, cancer or severe mental health issues. They include seniors and people with disabilities who will have to choose between paying for their medicine and buying groceries.

Last year, Republicans forced through these health care cuts in a partisan budget after passing a huge tax cut for the rich. Seniors, people with disabilities and many Maine families will be asked to shoulder the burden so more money can go to people who don’t need it.

In times like these millionaires should be giving to charity, not getting it.

The funds used for the tax cut could have helped fund the cost of the housing and care for people with severe developmental disabilities whom Malaby is concerned about. The families of those individuals, in many cases, will have to quit their jobs to care for them.

The truth is Democrats and Republicans agree that our health care system needs to be more affordable. We just have starkly different solutions for how to lower those costs. Taking health care away from Mainers in need is not reforming the system — and it won’t save taxpayers money in the long run. It will just create a cost shift.

Think about it this way: When sick people need care, hospitals cannot turn them away. Instead, they pass on those costs to people who do have insurance, or cities and towns have to pick up the bill.

If a 19- or 20-year-old who requires medicine for severe mental illness can’t afford his or her medication, he or she won’t be able to get or keep a job. They won’t be able to pay their rent or mortgage. Or, worse, they could become much sicker. Or what about the 19- or 20-year-old who can’t afford her insulin pump?

Taking care and medicine away from people who need it can be devastating, even deadly, for those individuals. And the domino effect is both economic and moral.

We all benefit when more people have insurance. It lowers costs for everyone.

Here is an astounding number: Five percent of the people who receive health insurance through MaineCare, or Maine’s Medicaid program, generate 55 percent of its cost. That’s because they are the most sick and need the most care. Democrats believe the best solution to lowering the state’s health care cost is focusing on better managing care for these people.

We’ve already seen pilot programs in the state making progress in these areas. Before the LePage administration took control, the state was on track to save millions more through managing member care than from the much smaller amounts projected from the GOP cuts.

Slashing health care for one set of needy people won’t help another set of needy people. Targeted reform that creates real savings and addresses the real problems in the system will.

It’s time Augusta got its priorities straight.

Rep. Mark Eves, D-North Berwick, is the lead House Democrat on the Health and Human Services Committee. He has served two terms in the Maine House.