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Noah Nesin is chief medical officer at Penobscot Community Health Care and chair of the Maine Prescription Drug Affordability Board.
Over the course of the past 11 months, we all have experienced the stresses associated with the COVID-19 pandemic. In the earliest weeks, we struggled to understand this disease and how we could best protect ourselves, sharing the fear engendered by early outbreaks and their devastation of vulnerable people.
We learned together about droplet and airborne transmission, R-value, asymptomatic spread and doubling rates. We yearned to know how best to protect ourselves and our loved ones, and when that information became apparent (masking and social distancing), we witnessed the politicization of science and the polarizing impact of that dynamic.
Our early successes in Maine and a summer respite offered figurative and literal breathing space. And sadly, as autumn brought the predicted surge in cases and deaths, worsened by holiday travel and gatherings, we bore the burden of our collective sorrow and grief. Now, with vaccination underway and case numbers and deaths dropping, we join together in hope that each of us, our loved ones and our neighbors will survive this pandemic, hope that fewer people will die from this terrible disease as winter fades, hope that the spring brings with it the beginning of the renewal of life as we knew it, less than a year ago.
It is in this moment that we must also consider the broad societal harm that this pandemic has wrought. According to the Brookings Institution, the economic impact of COVID-19 has included a dramatic drop in small-business revenue; in the first six months of the pandemic, 420,000 small businesses had failed. And it is projected that this month 4.5 million people will have been unemployed for at least 26 weeks, with another 2 million unemployed for more than 46 weeks. Low-income families with children have been the most likely to experience the most severe economic impact and Black and Hispanic households are especially vulnerable.
In a country where most of the workforce obtains health coverage through their jobs, the risks to health and health care are obvious. But in the 38 states and the District of Columbia where Medicaid was expanded, it will play a critical role in providing a safety net for individuals and families who have experienced the economic devastation of COVID-19. Here in Maine, voters had the wisdom to overwhelmingly approve MaineCare expansion, and in January 2019, Gov. Janet Mills made that a reality.
In the ensuing two years, more than 73,000 of our fellow Mainers have gained health coverage, and thousands have gained the benefits of access to health services like cancer screenings and treatment for chronic diseases. More than 14,000 have been able to obtain treatment for substance use disorders and more than 37,000 have gained access to mental health services.
At my own organization we have had the privilege of bearing witness to these life-changing experiences. A single mother treated for substance use disorder repairs her relationships, resumes her education and provides a loving home for her child. A young man with autoimmune disease who lost his job and insurance due to the pandemic is able to maintain otherwise unaffordable and critical medication. Our primary care teams hear countless stories like these and know firsthand how vitally important access to health care is to our patients and their families.
But with this economic downturn and the costs of any relief package there is bound to be a resurgence of concern about deficit spending and national debt, and with it the inevitable threat to gains made under the Affordable Care Act. We must all be vigilant in protecting these hard-won gains in strengthening protections for our fellow Mainers. We can do that by insisting that we not go backward on MaineCare expansion, and we can also make insurance more affordable through new revenue sources, like a state-based health insurance assessment proposed by Mainers for Working Families and Consumers for Affordable Healthcare.
Maine’s newly formed Prescription Drug Affordability Board has begun its work to recommend changes aimed at reducing the burden of pharmaceutical costs for the state. Here in Maine and across the nation there are countless innovations aimed at ensuring that no American has to face life without access to comprehensive health services. Now is the time to embrace those innovations.
The COVID-19 pandemic has resulted in unprecedented personal and societal stressors while simultaneously precipitating public health and economic crises. If we are not thoughtful about our response, millions of our fellow citizens will risk the loss of health coverage and the resulting costs in dollars and in human suffering will be staggering.