Over the next few months, legislators will discuss MaineCare costs, not just for this budgetary year.

They also will recognize that Barack Obama’s health care reform has exposed states to increased costs by expanding enrollment and reducing private coverage.

So before the cacophony of special interest groups, both members and providers, deafen the senses, maybe we stop and enjoy the history of Medicaid.

Enacted in 1965 under Title XIX of the Social Security Act, Medicaid is an entitlement program that was established to provide medical assistance to individuals and families receiving cash assistance, or “welfare.”

Over the years, Congress has expanded Medicaid eligibility incrementally to reach more Americans. Though many live below or near poverty, regardless of their welfare eligibility, they can now obtain benefits. Medicaid continues the practice of picking winners and losers by accepting one category of citizen over another.

Federal law outlines basic minimum requirements that all state Medicaid programs must meet. States, however, have broad authority to define eligibility, benefits, provider payment, delivery systems and other aspects of their programs deemed by federal law as optional.

As with all federal programs, the original intent was hijacked by the howls of self-interest groups, along with those enjoying political favor. Taxpayers as a group have failed to enjoy such political largesse.

The funding provided by the federal government relies on a printing press, paper and ink.

A state pays actual tax dollars.

This should be a time to look at service needs and delivery, current policy and administration, block grants and recognize the loudest voice is not always correct, no matter how many wheelchairs and children are bused in.

Bill Perfetto


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