March 23, 2018
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Remove one big barrier to reaching the American dream. Expand Medicaid

Troy R. Bennett | BDN
Troy R. Bennett | BDN
In this January 2014 file photo, Sgt. Robert Elliot tries to organize hundreds of people headed through security screening at the State House in Augusta before a Maine People's Alliance rally urging legislators to make accepting federal Medicaid funds and expanding health care a top priority.
By Diane Scalia, Special to the BDN

Historian James Truslow Adams coined the phrase “American dream” in 1931. He wrote that what attracted immigrants to America was the “dream of being able to grow to fullest development as man and woman, unhampered by the barriers which had slowly been erected in the older civilizations, unrepressed by social orders which had developed for the benefit of classes rather than for the simple human being of any and every class.”

Adams noted that this was a difficult concept for the European upper classes to grasp. Subjected to numerous contextual interpretations over the years, Adam’s concept more recently has been used to stereotype and deprive 70,000 low-income, hard-working Mainers access to health care.

Mental health is a subject often overlooked in the health care discussion. Maine’s mental health system has borne the weight of years of underfunding as the number of uninsured individuals has increased, resulting in needless suffering and increased burdens on Maine’s taxpayers. It threatens the future of our economy.

Half of all Americans will experience the symptoms of a mental illness during the course of their lifetime. Half of those conditions begin by age 14 and three-fourths by age 24. Maine is the most opioid-addicted state and is the only state in New England to not accept Medicaid expansion funding available through the Affordable Care Act.

According to the American Mental Health Counselors Association, there are 20,300 adults, age 18 to 64, who are eligible for mental health and substance abuse services covered by Medicaid expansion funds. Lower-income people are more likely to have mental health issues related to stress and poverty. Serious mental health disorders such as major depression, bipolar disorder, schizophrenia and panic disorder affect one in six uninsured adults with incomes below 138 percent of the poverty level.

Disorders like depression and anxiety caused by stressful life events such as bereavement, illness, homelessness and job loss are equally debilitating, affecting a person’s daily functioning and costing employers millions in absenteeism. Lack of timely care can cause mental health conditions to decline to the point of crisis, requiring more costly emergency and inpatient care funded with revenues from Maine’s general fund. Some individuals end up in the state’s county jails and prison system.

The Bangor Daily News reported that, in 2010, 79 percent of the people in need of treatment for substance use did not receive services. The state’s county jail budget for fiscal year 2010 was $82 million; Maine property taxpayers kicked in $62 million of that budget. Maine’s prison system, according to the Vera Institute of Justice, costs Mainers almost $47,000 per inmate. While individuals should account for their actions, my point is that an ounce of prevention is worth a pound of cure.

I am asking our legislators to consider the savings that Maine taxpayers could realize if one, two, 10 or more individuals received necessary mental health, substance abuse and relapse prevention services. These are dollars that could be better spent on education, infrastructure improvement, job training, housing and day care subsidies for single-working mothers who comprise 30 percent of Maine’s low-income workforce.

Do our legislators want to continue using our money to fuel a fire that has been out of control for years? Federal funds are waiting that will pay for 100 percent of the cost of extending health care to Mainers living up to 138 percent of the poverty level between 2014 and 2016, leveling off at 90 percent in 2020.

In 2016, Maine is estimated to receive $62 for every $1 it spends to expand health coverage — an estimated $256 million. Additionally, Medicaid expansion funding will create more than 3,000 new jobs that pay living wages. The clock is ticking. We are losing $500 for each minute spent debating this issue.

This Democrat supports Republican Sen. Roger Katz’s well-crafted bill, LD 1487, An Act to Provide Fiscal Predictability to the MaineCare Program and Health Security to Maine People. It gives the state’s MaineCare program a much-needed overhaul and puts health care in the hands of health care providers. More importantly, it removes barriers that hamper the well-being of 70,000 hard-working Mainers and threaten the state’s economy.

Diane Scalia of Orono is a masters of social work candidate at the University of Maine.


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