The U.S. Census tells us that 12,000 more Mainers were without health insurance last year than there had been the year before, bringing the total to 147,000. It also tells us who they are.
More than half are men, and more than half are between the ages of 35 and 64. Most of them — more than 80 percent — are working. More than 70 percent earn between $5,000 and $35,000 per year, putting them in the struggling class that is just a major illness away from poverty, homelessness or bankruptcy.
This is also the group regularly dismissed by Gov. Paul LePage as “able-bodied adults,” “younger men, smokers and drinkers,” who don’t deserve to be part of the MaineCare system. The governor is proud of his efforts to cut the state Medicaid budget by changing eligibility standards to eliminate coverage of 30,000 people. And he brags about his five vetoes of federally funded Medicaid expansion, which would have extended health insurance to as many as 70,000 Mainers. That would have cut the number of Maine’s uninsured in half, instead of adding to it.
This has been a pattern with the governor, who demeans the people who need help, and then tries to take the help away. We have seen three years of his approach to health care reform, which is enough to know that it won’t work.
LePage is identifying the wrong problem. It’s not that the MaineCare budget is too big, but that too many people are struggling economically to be able to afford health insurance.
Adding to their numbers has a perverse effect. Uninsured people are more likely to put off doctor’s visits and pay for treatment, making them sicker and more expensive to care for when they do seek help. If they can’t afford it then, they may receive charity care, which is passed on to the rest of us with in the form of higher insurance premiums.
A better approach would be to make sure that working people have health coverage and access to doctors and clinics, so they don’t have to rely on emergency care. The right response to high health costs is to help people lead healthier lives.
Both of LePage’s opponents in the upcoming gubernatorial election know this. Democrat Mike Michaud and independent Eliot Cutler both promise to accept the federal funds and expand MaineCare.
Bipartisan majorities in the state House and Senate know this, which is why they passed versions of MaineCare expansion five times. The value of this program is not a mystery to the nine Republican governors who already have accepted federal funding, while the Republican governors of Indiana, Utah, Tennessee and Wyoming are considering a change in their positions.
It’s also not news to hospitals. The number of uninsured patients is dropping nationwide, but this decline has been faster in the states that have expanded Medicaid than in the states that haven’t. HCA Holdings Inc., which runs more than 165 hospitals, saw a 6 percent drop in uninsured patients over the previous 12 months, but a 48 percent drop in the ranks of the uninsured in states that have expanded Medicaid.
Expanding Medicaid would bring federal money into Maine’s economy at a rate of $1 million a day. That would be given not to shiftless layabouts, but to doctors, nurses, lab technicians and clerical staff, who would spend it on rent, groceries, mortgages and car payments. It would generate economic activity, creating jobs that provide health benefits.
According to the U.S. Census, Maine is one of only two states — the other is New Jersey — where the number of people without health insurance is increasing instead of shrinking.
Thousands of working people here are trying to support themselves and their families, but can’t afford health insurance. Instead of a helping hand, they have been insulted and rejected by this governor and his allies in the Legislature.
The data show the costs of this policy — not just financial costs but human costs as well. It’s time to pay attention.