Once again supporters of expanding Medicaid in Maine are making inaccurate statements and disregarding our state’s past results with expanding MaineCare, Maine’s Medicaid program. There is a reason the LePage administration has rejected expansion five times. And this sixth attempt is not the same; it is worse. Previous proposals would have cost Maine taxpayers more than $300 million over the next five years. This latest attempt will likely be even more expensive given the experiences of other states.

Sen. Tom Saviello, R-Wilton, claims, “It’s just the right thing to do.” Allow me to explain why it is not only wrong but detrimental to the state.

Maine has already experienced the devastating consequences of expanding Medicaid and doing so again would be irresponsible and return Maine’s budget from its current state of stability to one of perpetual crisis.

Saviello is proposing the so-called “private option.” The private option isn’t private — it uses the same taxpayer dollars that would fund traditional Medicaid expansion. In most cases, it ends up costing more than traditional expansion, because of the rapidly rising cost of health insurance plans. So much for the “Affordable” Care Act.

The private option typically relies on a state purchasing Qualified Health Plans for a portion of its expansion population. Last year, when Nebraska considered implementing the private option, that state’s Department of Health and Human Services found that Qualified Health Plans — or publically funded private insurance for those earning 100 percent of the federal poverty level and above — would cost the state 94 percent more than traditional Medicaid expansion.

Saviello claims that his expansion plan is based on the success of other states. However, two of the states he cited — Kentucky and New Mexico — are facing massive Medicaid shortfalls.

There is no proof expanding Medicaid would reduce drug-fueled crime or resolve Maine’s substance abuse problem.

It would be great if complicated problems such as drug addiction could be so easily resolved by just throwing money at them. New Hampshire, for example, with the same population as Maine — and an expanded Medicaid program — had double the number of heroin overdose deaths last year. Even so, Maine continues to increase funding for treatment services, spending more than $20 million annually on the uninsured. Furthermore, federal funding provided to the states for substance abuse treatment has increased from $3 billion in 2005 to more than $13 billion in 2015.

Medicaid expansion backers argue expanding will enroll 60,000 working-age adults into Medicaid. In reality, that number is closer to 80,000. Every expansion state that has publically released its original enrollment projections has exceeded their enrollment projections, which has led to budget shortfalls.

Expanding Medicaid would move people off private insurance coverage that they already have onto taxpayer-funded programs.

Saviello claims he will not allow this to occur and will work closely with the federal government to make sure it does not happen. The senator, however, doesn’t have this authority. If the state expands Medicaid, Maine can’t choose who is eligible and who is not; it’s dictated by the federal government.

Other states have not been successful when it comes to working with the federal government on alternative Medicaid expansion plans. Jim Vokal with the Platte Institute in Nebraska stated, “In theory, the Legislature can put anything it would like in this bill, but in practice, LB 1032 [their proposed expansion bill] is just a dress-rehearsal for a negotiation with the federal government over a Section 1115 Medicaid waiver.”

Arkansas Gov. Asa Hutchison is facing a similar uphill battle — he tried to implement accountability reforms such as work requirements and asset testing. The Obama administration has told Hutchison that any asset test is off the table and that the state would not be permitted to implement a work requirement but only “work encouragement.” There is no proof Maine’s experience would be any different.

The Editorial Board is correct; it’s time to end the fight over Medicaid expansion.

When Maine expanded in 2001 and again in 2003, it led to annual shortfalls in MaineCare of $50 million to more than $100 million. It did not improve the uninsured rate and charity care was not reduced. It destroyed the state’s budget, caused the state to stop paying its bills leaving hundreds of millions in debt owed to Maine’s hospitals and left our state’s neediest and most vulnerable to pay the price.

It did not solve problems, it created them, a scenario playing out every day in states around the country as the financial and practical truth of massively expanding a government-welfare entitlement program comes home to roost.

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

filed under:

Augusta and Waterville news

Get news and events from your towns in your inbox every Friday.


  • This field is for validation purposes and should be left unchanged.