August 26, 2019
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Addiction care at heart of latest push for Maine Medicaid expansion

Maine Senate | BDN
Maine Senate | BDN
Sen. Tom Saviello, R-Wilton

AUGUSTA, Maine — Hoping to tap federal funding that could help fight Maine’s heroin addiction crisis, a pair of Republican state senators is again proposing legislation to expand Maine’s Medicaid eligibility.

Sen. Tom Saviello, R-Wilton, who previously has supported an expansion of the state and federally sponsored health insurance program for low-income families and individuals, said his bill — essentially a “placeholder” that was carried over from 2015 — will go before the Legislature when it convenes in January.

One of a handful of Republican lawmakers who support Medicaid expansion in Maine, Saviello said Monday he knows his legislation, co-sponsored by fellow moderate Republican Sen. Roger Katz of Augusta, faces an “uphill fight.”

Expanding Medicaid in Maine as allowed by the federal Affordable Care Act would add an estimated 60,000 people to the state’s Medicaid rolls.

Meanwhile, the number of documented drug overdoses from heroin or other opioids, including prescription painkillers, has reached its highest level since state medical officials have been keeping track.

Earlier this month, in a letter to the state’s top medical professionals urging them to use greater caution in prescribing painkilling medications, Maine Attorney General Janet Mills noted that on average, five Mainers a week are dying from overdoses.

Democrats in the Legislature have been united in their support of expansion, which President Barack Obama’s administration has touted as a key component of health care reform. But Republican Gov. Paul LePage has five times since 2013 vetoed bills that would have expanded the state’s Medicaid program, and legislative Republicans have voted to sustain those vetoes.

Supporters of expansion — who note that the federal government would fund at least 90 percent of the eligibility expansion — have been unable to muster two-thirds support in both chambers of the Legislature, which would be needed to override another expected LePage veto.

“As Yogi Berra said, ‘It’s deja vu all over again,’” Adrienne Bennett, a spokeswoman for LePage said in a message to the Sun Journal. “The results were disastrous for Maine when it expanded this kind of welfare in 2002, and it is now blowing holes in state budgets around the country.”

Bennett said Illinois, Rhode Island, Ohio, New Mexico and California all saw their budgets decimated by Medicaid expansion.

“We rejected Medicaid expansion five times, and we will reject again, no matter how many times liberal politicians push for it,” Bennett said. “Unfortunately, there are some politicians using a real addiction pandemic to push welfare expansion to score political points in an upcoming election year. The governor doesn’t play that game.”

Given Maine’s addiction crisis, Saviello said it’s time the state takes advantage of federal funds meant to provide health insurance to individuals with incomes less than 138 percent of the federal poverty level or about $16,105 a year for a single person.

Saviello said drug addicts who end up in jail for committing crimes to support their habits are often too poor to afford health insurance, so when they are released from jail, they return to a cycle of crime and substance abuse without treatment and counseling.

It makes more sense to provide people with health care coverage via Medicaid, which would see the federal government cover most of the costs of substance abuse treatment and counseling, according to Saviello.

“This is about drug treatment, and we are sitting on megabucks on the border of the state of Maine, to come in here and help low-income individuals with counseling and treatment,” Saviello said.

Sen. Eric Brakey, R-Auburn, who opposes Medicaid expansion, said Saviello and Katz are unlikely to garner enough support to move the legislation to law.

“It’s going to be just as dead on arrival this year as it was last year,” said Brakey, Senate chairman of the Health and Human Services Committee.

Brakey said he and other Republicans doubt the federal government will sustain the high subsidies for Medicaid expansion and don’t believe Maine would be able to afford a Medicaid expansion on its own.

“You can look at so many states between here and California, that we consistently see this pattern over and over again — the fiscal projections on what it is going to cost are oftentimes very optimistic, and it ends up costing the taxpayers of the state way more than that,” Brakey said. “And this doesn’t take into account the simple fact that the federal government is broke.”

Brakey said his committee also will consider at least one bill that seeks to increase state spending on addiction treatment in concert with a call for more officers for the Maine Drug Enforcement Agency.

Brakey said he has yet to receive information on how any of the new spending would be funded.

Saviello countered Brakey’s argument with a claim that Mainers who are paying higher insurance premiums to cover the cost of uninsured individuals or to make up for reduced federal payments to health care providers — money that’s instead being used to provide health insurance coverage to low-income people in other states — are already paying more.

He also questioned whether reports of Medicaid spending explosions in other states present the entire picture, noting that New Hampshire hospitals are seeing a reduction in the amount of “uncompensated care” they provide to uninsured individuals.

“They’ve seen a 17 percent reduction in the amount of unpaid claims to their hospitals,” Saviello said.

Saviello urged LePage to set aside his political differences with Obama and emulate New Jersey Gov. Chris Christie, LePage’s choice for president in 2016. Christie agreed to expand Medicaid in New Jersey under the ACA, Saviello said.

“We have a great opportunity here, and we keep blocking it because of ideological differences. That’s what this is all about, it’s ideological differences,” Saviello said.

 



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