I am writing in response to the Feb. 4 column, “MaineCare waiting lists for extra services, not medical care,” written by Lisa Miller regarding current waiting lists for persons with developmental and intellectual disabilities. The author argued that the issue of our most vulnerable on waiting lists for critical services is somehow a separate issue from whether we should spend limited state resources on expanding Medicaid to 70,000 able-bodied, non-elderly adults.

This nonsensical assertion by those who wish to commit the state to spending hundreds of millions of state dollars on Medicaid expansion implies we have unlimited resources. They believe we can meet everyone’s needs and inaccurately characterize expansion as being free.

In his State of the State address, Gov. Paul LePage recognized the challenges of Cynthia and Paul Levasseur of Carmel, whose son, Michael, has autism and needs 24-hour supervision. The Levasseur family and many more families throughout Maine know the reality of broken state promises and the failures of the current system to provide for those who most need and depend on state government.

For years, the state has been expanding Medicaid, failing to a cover the costs of the program, leaving health care bills unpaid and even worse, sacrificing the needs of the elderly and the disabled. To right this wrong, LePage has worked to establish a Medicaid program the state can afford, with a core mission of ensuring that those most vulnerable receive critical services they need to live as independently as possible. LePage has demonstrated real commitment to the disabled and elderly on waiting lists.

Last year, he submitted a budget that increased the total funding for services to reduce the waiting lists by more than $10 million over the two-year budget cycle. Miller’s statement that “all of the people in these vulnerable groups already receive Medicaid (MaineCare) or have other coverage for the medical care they need” is insulting to the more than 3,000 individuals waiting for services. We have elderly parents trying to care for their adult children with developmental disabilities at home at a time when their declining physical health threatens their ability to meet their children’s needs. Many adults on the waiting list can no longer live safely at home, let alone afford to pay for a group home.

With services, people such as Michael could get a job coach, assisted-living accommodations and participate in a day program. These services can be provided in the community and will allow for a more productive, independent life outside of more costly institutional care.

The waiting list of more than 3,000 individuals also includes services for our elderly. We cannot sit back and allow limited resources to be consumed by expansive new programs when the state today is not adequately funding important services for our elderly to help them stay in their homes and communities.

For years, previous administrations chased federal dollars expanding programs and services, abandoning fundamental responsibilities including basic support services for our elderly that cannot be paid for by the federal government. This thirst for federal Medicaid money has come at the expense of other programs in the Department of Health and Human Services and across state government — mental health services, supports for foster families, education, state police, employment services, small farmers and natural resources to name a few.

Suggestions by Miller and others that expanding tax-funded health care to nearly 70,000 younger, able-bodied adults would not affect the state’s ability to fund services for those on waiting lists is nonsensical. Common sense dictates that each state dollar spent on the able-bodied is a dollar taken away from those whose needs we currently do not meet.

Expanding Medicaid to the able-bodied would require additional infrastructure costs and is projected to cost Maine more than $800 million over the next decade. Maine does not get 100 percent of this program paid for in the first three years, contrary to the repeated media reports. Even the additional federal tax dollars that are assumed would be constantly in jeopardy as the nation continues to face financial crisis and budget deficits.

Maine taxpayers shouldn’t be asked to sign a blank check to give Medicaid to 70,000 adults who can work and many of whom qualify for help to buy their own insurance. More importantly, disabled and elderly Mainers shouldn’t have their needs ignored in order to fund this expansion.

The LePage administration is committed to making sure that people like Michael and his family receive the support they need. Miller may disagree, but this administration’s decision is to focus our energy and resources on serving the disabled and elderly who need us most.

Mary Mayhew is commissioner of the Maine Department of Health and Human Services.