Just months after Maine voters said they wanted to expand health care access through the Medicaid program, the LePage administration is still trying to cut it back.

Working with allies in Washington, Maine is vying to be one of the first states in the country to discourage participation in Medicaid (known here as MaineCare) through work requirements.

The state has also applied for permission to impose lifetime caps on eligibility, something the feds are said to be considering.

Neither of these rule changes would save the government much money, but they are valuable PR for politicians like Gov. Paul LePage who want to pin the high cost of health care on fictional layabouts who choose not to work. The reality is that most of the money in the program is spent on people who cannot work, because they are children, elderly nursing home residents or people with disabilities.

Two-thirds of the relatively small number of Maine adults on MaineCare who are not over 65 or disabled have jobs, and 80 percent live in a household where someone is working.

According to the Kaiser Family Foundation, virtually all of the people who don’t work and would be affected by the new rules either have health problems themselves, or are caring for a family member.


So what does making them fill out paperwork or show up for a volunteer job accomplish?

These are the arguments LePage and others made when the Medicaid expansion went before the voters last year. But the voters of Maine did not listen. By a nearly 20 percent margin, they supported adding 70,000 people to the program.

LePage is using the federal rules to get around the law the voters passed, and he should not get away with it.

MaineCare is health care, not welfare. People on the program don’t get a check every month that discourages them from working. But they do get a chance to go to see a doctor when they are sick, or fill prescriptions that keep chronic diseases at bay.

Adding more hurdles to applying for benefits will inevitably result in eligible people failing to be enrolled. The bureaucratic nightmare of trying to figure out who has received how much coverage during their lifetimes would slow the process for everyone.

LePage speaks very eloquently about the psychological benefits of having a job. He is right. People who work are healthier, less isolated, and less likely to be depressed.


But cutting off someone’s health care is not going to make them more likely to work — just the opposite is true. Illness is one of the main barriers that prevents people from working.

Mainers are dying at the rate of one per day from opioid overdoses, and experts believe that those who die represent a fraction of the people who are addicted to the drugs.

Two-thirds of Mainers are overweight and 20 percent use tobacco, the two leading preventable causes of disease and death.

If LePage were serious about cutting the MaineCare budget and getting people back to work, he could commit to policies that would reduce demand for health services over time. Money invested in drug treatment, smoking cessation, nutrition education and the promotion of exercise would do far more to get people in shape to work than taking away their health coverage.

That’s the approach Maine voters took last fall, and that’s the approach Maine’s elected officials should take as well.

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