March 19, 2019
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Here’s one way to support Mainers’ health: expand Medicaid

Robert F. Bukaty | AP
Robert F. Bukaty | AP
Mainers for Health Care rally outside the State House prior to Gov. Paul LePage's State of the State address, Tuesday, Feb. 13, 2018, in Augusta, Maine. The coalition that supported the successful Yes on 2 campaign to expand Medicaid in 2017 say LePage and his allies in the Legislature are trying to block Medicaid expansion, which is now state law.

Over half of Maine hospitals are losing money and are at risk of future financial failure. The core problem is that the medical services they render all too often go unpaid. At the same time, up to 25,000 of our fellow Mainers urgently need drug addiction treatment they cannot afford and are going without.

While not the worst state in the union, Maine is near the top for per-capita deaths caused by opioids. Maine is also the only state to see its infant-mortality rate go up in the decade between 2005 and 2014, compared with the previous decade, 1995-2004.

Funds for caring for these unfortunate citizens and children are not sufficiently available, leading to devastating and costly long-term health care and social consequences. Expanding MaineCare, the state’s Medicaid program, could make a meaningful difference but all five Republican gubernatorial candidates profiled in the Bangor Daily News won’t support it, apparently because it is a mostly government funded program. Of course, nearly 60 percent of patients’ health care in Maine is already supported by government programs without which many more Mainers would go without treatment for a wide variety of health issues.

The fact is that health care of any kind, not just addiction treatment, has become unaffordable for far too many Mainers

The Legislature has passed MaineCare expansion five times but was not able to override the governor’s veto. A clear majority of Mainers — 59 percent — supported an expansion referendum last November, but the governor now claims that President Donald Trump’s administration will only permit states to expand Medicaid coverage if state legislatures allocate the funding required to cover administrative costs. Gov. Paul LePage has stated that he will not enact the peoples’ mandate until the Legislature finds a way of doing so without raising taxes. Thus, Maine loses out on approximately $500 million in federal Medicaid funding each year, money that could be available in July.

The Associated Press reported that “The Office of Fiscal and Program Review projects $54 million in annual state Medicaid costs after $27 million in savings, while the Maine Health Access Foundation estimates $62 million after savings.” Either way, the federal government would provide roughly $525 million — more than 90 percent of the cost of expansion — in annual funding and, aside from the obvious health care benefits, that makes for a very meaningful boost to Maine’s economy.

Maine currently has a budget surplus that could accommodate the voted-for expansion, but since our Legislature has not been able to agree on its priorities, it looks as though MaineCare expansion will have to wait for a new governor and Legislature.

Meanwhile, all of us continue to support expanded Medicaid for every other state that has accepted it, through our federal tax contributions, without getting similar increased benefits for our state. So Maine misses out on urgently needed programs that would benefit thousands of patients, save lives and significantly help our rural hospitals.

While Medicaid may not be the optimum solution to our state and national health care crisis, it currently provides the only practical way of subsidizing the health care of people who otherwise cannot afford or obtain necessary treatment, and it is an effective way of supporting the financial viability of many hospitals.

If our Legislature won’t meet LePage’s demand to fund the administrative cost of expansion without raising taxes, will at least one of the Republican gubernatorial candidates acknowledge the people’s mandate and support its enactment?

John M. Long has been a registered Republican for most of his life and is a retired physician living in Bangor. He has served for 28 years as chief of radiology at the Eastern Maine Medical Center and is a co-founder of the Spectrum Medical Group. Bob Ziegelaar is a registered Democrat and lives in Bangor. He is a former aviation executive and currently operates MainXPO Inc., a business consulting firm.

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