Here we go again. Medicaid expansion has failed in the Legislature five times, so now it is coming directly to the voters. As a legislator and as a health insurance agent who serves individuals through, I urge Maine to vote “no.”

Health care is both personal and complicated. Fear drives human nature to make rushed and uninformed decisions. This referendum is about playing to emotions; emotional decisions are not sound decisions. The unintended consequences are grave; Maine taxpayers cannot afford it, and individuals utilizing Medicaid need to know that this could cost them personally, too.

There is nothing more terrifying than the thought of getting a serious illness or disability that leaves you destitute and dependent on others. I get it. This is the reason people come to me for health insurance.

Health insurance is a vehicle to help protect your health and your assets. It is a product designed to help you get ahead. Mainers earning just $12,060 a year are eligible for very affordable private health insurance. Medicaid, in contrast, holds you back.

Medicaid is a safety net that protects our most vulnerable citizens. In Maine, today, very low-income seniors at or below 175 percent of federal poverty level receive help from Medicaid. Across the country, the benefit for low-income seniors is at 135 percent. Maine’s program is very generous.

Additionally, Maine’s Medicaid program covers pregnant women, low-income children and the disabled. Despite our generous program, Maine still has a waiting list for our most vulnerable Section 21 and Section 29 residents with severe developmental disabilities. These Mainers should be our focus. But under this referendum, they are not.

Instead, Medicaid expansion will extend benefits to non-disabled, working-age adults. This will not only strain our Medicaid system; it will also harm our economy, stifle and restrain our able-bodied, cost taxpayers an estimated $50 million to $100 million a year — and it could cost the people who utilize the benefits personally. That’s right! If you are able-bodied with assets, under the federal law, states that expand Medicaid can do asset recovery. Which means, upon your death, Maine comes first. This is a huge setback. Why go down that road when you don’t have to?

Last year, Maine voted to increase the minimum wage. Today, Mainers need only work 26 hours a week to qualify for Obamacare. Because Maine didn’t expand Medicaid, able-bodied Mainers at 100 percent of federal poverty level have access to very affordable private health insurance. To give you an idea: A 30-year-old earning $12,060 a year in Cumberland County can get insurance for under $15 a month!

This is a win-win-win-win. A win for the individual — who has a choice of insurance and a choice of doctors. A win for Maine — taxpayers aren’t paying. A win for Maine’s economy — across Maine there are “Help wanted” signs, and businesses need our able-bodied residents working. A win for doctors, hospitals and health care networks — which receive higher reimbursement rates from private insurance companies than from Medicaid. Doctor networks suffer when too many patients are on Medicaid because reimbursement rates are low. Doctors need a sustainable payer mix that balances Medicaid’s reimbursement rates with private insurance’s reimbursement rates.

My clients at 100 percent of federal poverty level are happy with their health insurance. Obamacare delivered a promise when the program first rolled out: “If you like the plan you have, you can keep it. If you like the doctor you have, you can keep your doctor, too.” It’s time to honor that promise.

If Medicaid expansion passes in November, individuals at 100 percent of federal poverty level will not be able to keep their health insurance. Instead, they will be forced into Medicaid. Unless their doctor accepts Medicaid, not only will they not be able to keep their insurance, they may not be able to keep their doctor.

For the love of Maine and the people I serve, I care deeply about people’s health and well-being. This issue is paramount to me. Legislators have looked at Medicaid expansion five times. Bills are carefully read and worked on in committee. Bringing this complicated issue to referendum allows the people to be a lawmaker for a day when the vote. Casting an emotional vote without reading and working on the bill will have grave unintended consequences. Voters should vote “no.” Medicaid expansion is bad for Maine.

Karen Vachon is a second-term Republican state representative from Scarborough and a licensed health insurance agent. She can be contacted at: [email protected]

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