The governor’s decision to not “lift a finger” to set up Maine’s health insurance exchange and to not otherwise take advantage of the Affordable Care Act is a missed opportunity for the governor and our state. The ACA is here to stay. It was passed by both houses of Congress, upheld in large part by the U.S. Supreme Court and reaffirmed by a majority of the people with the re-election of President Barack Obama. It is now “the law of the land.”
The question now is: Will Gov. Paul LePage lead us in taking full advantage of the law for the benefit of the people, or will he continue to fight it by not acting, by not participating, by not “lifting a finger”? Can he now put the people of Maine above tea party politics? By putting people above politics the governor can lead in the redesign of the health care and health insurance systems in Maine. By “lifting a finger” to help set up Maine’s health insurance exchange, we can design insurance policy benefits that focus on our needs as Mainers, with an emphasis on health, as well as insurance. The ACA allows each state to design and adopt state-specific required minimum benefits that we, as Mainers, need and can afford. If we don’t participate, we get whatever some bureaucrat in Washington and insurance company lobbyist comes up with.
By “lifting a finger” and agreeing to participate in the ACA Expanded Medicaid Coverage Program, we have the opportunity to provide health care coverage to approximately 44,000 Mainers who cannot otherwise afford it. We get to provide this coverage at a fraction (10 percent) of the cost that it would otherwise cost the state. This added coverage means that hospitals and doctors will have to do less charity work that is now passed on to Maine taxpayers and those who purchase private insurance policies. Not to mention that coverage will better manage chronic illness, reduce costs and have better health outcomes in the future.
By “lifting a finger” and proactively participating in the provisions of the ACA that are intended to help Maine’s elders and growing aging population, the governor could take the lead in creating a health care system for Maine’s elderly that calls for better care, placing the emphasis on value and not volume, quality and not quantity. Provisions of the ACA encourage states to develop a system that will keep Maine elders home, rather than in a nursing home; compensates doctors for providing at-home care to Maine’s elders; calls for improved hospital-to-home transition care, thereby reducing hospital stays for Maine’s elders; and sets aside $3 billion to fund stay-at-home services, with the goal of helping elders age at home. The waiting list in Maine today for some of these services is 1,100 names long. These ACA long-term care provisions are exactly what is needed in this state as our population ages and more caregivers are needed.
In short, by “lifting a finger,” we get to take the lead. We get to decide what is best for us and our state. We get to take advantage of the law, rather than letting the law take advantage of us.
John E. Nale is an elder law attorney with offices in Waterville.
Nobrainer, LePage. Lift more than a finger (and one other the the middle digit) and lead. For a change.
I wouldn’t hold my breath waiting for that dipstick to help anyone not connected to the Heritage Foundation.
The only time LePage lifts a finger for anything is when it and a few more are wrapped around a fork.
Maine is not alone ,many states have not lifted a finger
Life a finger get stuck with the bill. Let the feds do it.
In the meantime:
“rather than letting the law take advantage of us”
The law passed, that is going to happen anyway. Why help it?
Speak for yourself, we should “help” it.
The law is an Obomblemess.
$100 million is the estimated yearly cost to run the program in other states who have decided to pay for it themselves. Let me know when the savings start.
Seventeen states have elected to set up state health insurance exchanges. Thirty-three have elected not to. It’s just barely possible this may mean LePage knows a turkey when he sees one.
Turkey or not, LePage cannot “veto” the ACA. By choosin to “not lift a finger”, he is giving the control to someone else. He would be better off letting Maine design their own program, rather than receive a cookie cutter program designed by the federal government.
As I understand it, the state-run exchanges are so tightly controlled by federal regulations that all the states really do is pay for them.
As you understand it, the ACA contains provisions for “death panels”. Try changing the channel from Fox and retune the radio from Rush.
Don’t you folks ever get tired of that meme.
All the more reason to take more control. Note well, Governor.
The notion that you are giving up control is a false one. I am willing to bet the real reason that more than 30 states refuse to sit up their own exchange is the cost and obfuscation. The ACA is a nightmare for the states why should they then assist in the slitting of their own throats.
States aren’t given rights.. States have the last say for what is best for it’self.. The Feds have overstepped their boundries on this one.
” It’s just barely possible this may mean LePage knows a turkey when he sees one.”
Since he looks in the mirror every day, i’m skeptical on this claim.
Mr Nale, We cannot choose the essential benefits. HHS has told us we must include their ten essential benefits. They also have told us we can choose only one of the three most popular plans currently being used in our state or one of the top three for Federal employees. Getting us down to one size shoe to fit everybody.. It is typical government thinking. There are hundreds, maybe thousands of ways we could design health care plans for our state, but HHS wants us to choose only one of the most popular ones. Not one, or several that may work for us. They have laid down very limited guidelines so severe that we might as well save the money from setting up their exchanges and hiring staff and let them do it. All the ACA benefits you say we may lose will not be lost because they are in the ACA, the law of the land whether set up by us or the Feds.
LePage is against the ACA. He doesn’t know why, he is just against it. He is patiently waiting for an explanation from the Koch brothers as to why he is against it. He will let us all know as soon as he does. Seems fair enough to me.
States, States formed a union called the United States, The federal Government does’t have any right in dictating what a State shall do.. The supreme court was playing politics and Roberts was extorted or bribed because he knew the federal goverment can’t mandate a contract..
The federal government has over steped its rights to many times already.. I do not blame states for wanting to get out of a overstepping union.. Just like Russia it will happen here if they don’t get out of a States business.. If we paid all our taxes to the State we would be able to take care of ourselves without the threat of having funds withheld if we don’t obey which so be concidered extortion.. The Federal Government who’s home is on sorverein territory needs to stop there over stepping of the constitution.
Gov. LePage won’t lift a finger because he knows that the heart of the ACA depends on expanding Medicaid. ACA supporters know that without the Medicaid option, those people will remain uninsured, won’t be able to afford to purchase insurance, and the whole system will remain stressed and dysfunctional and the ACA will fail. To say nothing about the fact that people without insurance die prematurely – one person every 3 days in Maine, in fact. We need Medicare for all. Here’s an interesting incremental option contained within this article: http://www.newmainetimes.org/articles/2012/12/24/smart-money-entitlement-reform/