For the sixth time since 2013, a debate is underway in Augusta about the merits of Medicaid expansion. But the proposal before lawmakers isn’t the same-old, same-old.

State Sen. Tom Saviello, who crafted the measure, has drawn on the experiences of other states and come up with a plan that could save thousands of lives, reduce crime and lower corrections costs — if his fellow lawmakers are willing to put aside preconceived notions and look at the facts.

The plan put forward by Saviello, a Wilton Republican, would help about 60,000 poor and low-income Mainers access health insurance.

People below 100 percent of federal poverty level (about $16,000 a year for a family of two) would be covered by Medicaid. Those earning between 100 percent and 138 percent of poverty level (about $22,000 for a family of two) would be able to buy subsidized private insurance, for which they’d pay a small monthly premium.

The measure goes straight to the heart of one of Maine’s biggest public health problems: the drug crisis. Maine has seen a surge over the last several years in both heroin overdose deaths and the number of people seeking treatment for opiate addiction.

But cutbacks to Medicaid here have made it harder for low-income addicts to get long-term outpatient treatment and driven up the number of people caught in a cycle of short-term detoxification and relapse — in turn raising the risk of drug-related crime and incarceration.

It’s no surprise, then, that members of the Maine Sheriffs’ Association and the Maine Chiefs of Police Association have voted to endorse Saviello’s plan. Sixty percent of county jail inmates in Maine have substance abuse problems, according to Sagadahoc County Sheriff Joel Merry. Without treatment, they’ll continue to re-offend – and keeping people behind bars is expensive.

Meanwhile, states that have expanded Medicaid coverage, including Colorado, Michigan and Ohio, have already saved $5 million to $13 million a year in criminal justice costs, the State Health Reform Assistance Network has found. In those states, the expansion has lowered the cost of treating inmates, improved efforts to prevent drug relapse among freed prisoners and slashed recidivism.

Saviello’s proposal would sunset expansion after two years if legislators don’t vote to renew it. This provision addresses a concern repeatedly raised by expansion opponents: that the U.S. government will renege on its commitment to funding expanded Medicaid, picking up 100 percent of states’ Medicaid expansion costs through 2016 and gradually reducing that to 90 percent by 2020.

The measure would also allow low-income Mainers who already have private insurance to keep that coverage. Saviello learned from the example of Arkansas, which has incurred extra costs by requiring Medicaid expansion participants to drop private market coverage.

It’s time to end the fight over Medicaid expansion. Instead of using outdated talking points to justify brushing aside Saviello’s proposal, legislators should advance the bill and embrace this opportunity to make a difference.

Only subscribers are eligible to post comments. Please subscribe or to participate in the conversation. Here’s why.

Use the form below to reset your password. When you've submitted your account email, we will send an email with a reset code.

filed under: