As we debate MaineCare expansion, I think a lot about “able-bodied adults” who do not have health insurance. I meet them every day at work. Many working Mainers cannot afford health insurance. If they find affordable ACA policies, they cannot pay the high deductibles, and often see no point to buying ACA insurance.

Maine law states that hospitals must provide free care to Mainers earning less than 150 percent of federal poverty level. Hospitals provide partial free care to people making less than 200 percent of federal poverty.

Adults who cannot afford health insurance often do not get medical care until they have costly emergencies, at which time they use “free care” to cover their bills. This drives up health care costs for all Mainers, and results in Maine losing hundreds of living wage jobs. The cost of expanding MaineCare is much less than we already pay now for the uninsured.

The “able-bodied adults” I meet who are not working care full time for children or elders; or they lack the skills, transportation, child care or stable housing needed to sustain liveable wage work; or they have serious health problems but do not qualify for SSDI or MaineCare.

Ideally, we could employ all of these adults in purposeful paid or volunteer jobs. In reality, rural Maine lacks the vocational rehab and other support resources needed to engage everyone in work.

I understand insured, working Mainers’ frustrations that we work hard every day to make a living and afford health insurance, while others seem to be getting things for free. It would be wonderful if we could all have the same basic health care benefits; and it’s important to keep looking at where our state spends health care dollars. In the meantime, expanding MaineCare is the compassionate and cost-effective thing to do.

Rebecca Dorr

Mount Vernon

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