Access to affordable health care is essential in promoting a humane and productive society. The success of the Affordable Care Act in improving access to affordable and comprehensive health care coverage was demonstrated this summer in Maine and across the country with the large turnout of voters demanding Republicans abandon their effort to repeal the law.
Right now, there is bipartisan support to expand MaineCare, the state’s Medicaid program, under the Affordable Care Act. The Maine Legislature has passed expansion five times, only to have their hard work meet with the governor’s veto pen backed up by a handful of his ardent legislative followers. But despite this opposition, the tide in Maine, as in most of the country, has turned. Mainers will be given a chance in November to remedy this political folly by voting on a referendum to expand MaineCare.
States that chose to expand Medicaid are faring quite well. Even though they can at any time stop participating, none of the 31 states that expanded their Medicaid programs have pulled out. Governors from expansion states, Republicans and Democrats, have strongly urged Congress not to repeal Medicaid expansion. It seems that good health is good for the economy as well.
While some continue to argue Maine can’t afford expansion, New England states and other expansion states have found the benefits far outpace the costs. Millions have been given access to health care and state budgets have experienced a boost. The New Hampshire Hospital Association found that emergency room visits fell 30 percent the first year after expansion, while addiction prevention groups in the Granite State pointed out that new federal funds could be used to address the opioid epidemic, potentially saving state taxpayers millions of dollars.
Michigan has saved $235 million from expansion as it uses new federal funds to replace state funding for community and correctional mental health services. Kentucky is forecast to see an estimated $819.6 million positive impact by 2021. Audrey Tayse Haynes, who served as secretary of the Kentucky Cabinet for Health and Family Services, said: “I don’t know any other way of describing it except as a win-win for us.”
The numbers projected by the Maine Center for Economic Policy tell a much different story than our governor’s warning about the cost of MaineCare expansion. It is estimated Maine would receive about $320 million in new federal funds annually once MaineCare expansion is fully implemented. Our state also would experience at least $27 million in budget savings. These figures don’t include additional tax revenue that would be generated by the more than 3,000 good-paying jobs that would be created. More than 12,000 health care-related jobs were created in Kentucky during the first year it expanded its Medicaid program, and job growth there continues.
The ripple effect to Maine’s economy would likely be enormous. Since enactment of the Affordable Care Act, the governor and his allies have left more than $1 billion in federal funds sitting in Washington, D.C., instead of being spent here in Maine.
One overarching issue can no longer be ignored. The opioid epidemic has focused attention on Maine’s lack of coverage for people in need. Expansion would provide Maine with much needed resources to build upon our treatment options and improve access to treatment for the many who have been left out in the cold.
The state also would save money in its criminal justice system. Other states, including Ohio and Illinois, are using expansion funds to provide drug and mental health treatment to prisoners once they are released from jail or prison, which in turn lowers relapse rates and recidivism. Medicaid expansion funds can be used to provide services through drug courts, which also have proven to be effective in reducing recidivism and incarceration and health care costs.
Finally, should the nightmare of repeal actually be realized by pugnacious federal legislators in the next year, Maine will receive less federal health care assistance, with unforgiving spending caps for Medicaid. This outcome will punish poorer and older states like Maine. MaineCare expansion, on the other hand, would be an opportunity to provide affordable health care for nearly 70,000 Mainers, including 3,000 veterans and the working poor who fall between the cracks.
This truly would be a “win-win” for Mainers and the economy of our state. In November, go to the polls and cast a “yes” vote to expand MaineCare.
Arthur Barry Adoff of Veazie is a writer and graduate student at the University of Maine School of Social Work.