May 20, 2019
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LePage would fit in well among those Trump considers ‘experts’

Troy R. Bennett | BDN
Troy R. Bennett | BDN
Republican presidential candidate Donald Trump shakes hands with Maine Gov. Paul LePage during a rally in Portland, Aug. 4, 2016.

Maine’s first couple in November recounted their experiences with bariatric surgery to a conference of medical professionals.

During the address to the American Society for Metabolic and Bariatric Surgery, according to a report in the Sun Journal late last month, Gov. LePage talked up his connections to the Trump White House.

“Every time I meet with the president and the vice president, we talk about how we need to reform America,” LePage said. “And I’m considered one of the experts in the whole area of Medicaid, Medicare and health care, as well as reforming welfare.”

There’s plenty of evidence that the Trump administration doesn’t value actual subject matter expertise. The administration’s nominee to serve as the U.S. Department of Agriculture’s chief scientist lacked any scientific or agricultural credentials. Multiple Trump judicial nominees have lacked trial experience; one notably couldn’t answer basic legal questions. Trump’s interior secretary, Ryan Zinke, reassigned a climate scientist, who grew up in Maine, to oversee accountants instead.

To consider LePage an expert, then, fits a pattern. But it’s still an unsettling thought.

To start, LePage seems confused by the basics surrounding Medicaid, as he’s shown repeatedly during the state’s multi-year debate over expanding the public health insurance program. During an appearance on Maine Public’s “Maine Calling” show in May 2016, LePage misstated basic facts about who qualifies for Medicaid in Maine and who doesn’t, and the fiscal details of expanding Medicaid under the Affordable Care Act.

“The state of Maine accepts people up to 200 percent of poverty,” he asserted to host Jennifer Rooks. “Medicaid is 138 percent of poverty.”

He later stated that adults without children are “one of the groups that do not qualify above 138 percent of poverty,” disputing a low-income adult caller’s assertion that she qualified neither for Medicaid nor for federal subsidies to help her purchase individual insurance under the Affordable Care Act.

In Maine, the state’s Medicaid program doesn’t cover non-disabled adults without children at all, due to cuts LePage pushed through early in his administration. The Medicaid expansion under the Affordable Care Act that LePage vetoed multiple times and that voters approved in November extends coverage precisely to that population.

Medicaid is available only to some parents (those with incomes up to the federal poverty level), pregnant women, children, and residents with disabilities.

In other words, its reach is much more limited than LePage seems to believe. And the governor also appears to misunderstand the extent to which the federal government, by law, pays for Medicaid expansion.

“Maine does not get the extended benefit of the 90-10 percent,” LePage asserted to Rooks. “Everybody thinks we do. We don’t. We never did, we never will.”

Throughout most of the country, the federal government, in the long term, will cover 90 percent of the cost of expanding Medicaid to low-income adults the program hasn’t previously covered. In Maine, the majority of the population to be covered — non-disabled adults without children — would be subject to the 90-10, federal-state funding split. The remaining adults to benefit — parents with incomes between 105 and 138 percent of the federal poverty level — would be funded at the same rate the federal government funds the rest of Maine’s Medicaid program, which is currently a 64-36, federal-state split.

In the area of health care, LePage has also demonstrated ignorance. The response to Maine’s opiate addiction crisis must involve medical treatment. Yet LePage has stated he’s “been trying to close down methadone clinics since I’ve been governor,” his administration has imposed an arbitrary two-year cap on Suboxone and methadone treatment covered by Medicaid, and he’s denied that the overdose-reversing drug naloxone saves lives. “[I]t merely extends them until the next overdose,” he wrote in a 2016 veto letter.

When it comes to “reforming” welfare, LePage’s policies have been focused squarely on cuts that he’s asserted have actually made life better for the people losing food assistance and cash benefits. Yet reports issued by his own administration disprove his assertions, showing that kicking people off food stamps and Temporary Assistance for Needy Families has not helped people gain work or earn incomes that help them escape poverty.

In a Trump administration that prefers not to see federal employees use the phrase “evidence-based,” LePage would fit right in as an expert.

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