Two years after Gov. Janet Mills issued Executive Order 1, implementing the voter-approved expansion of health care through Medicaid, the program is proving invaluable as Mainers continue to experience the public health crisis of COVID-19 and the economic downturn caused by the pandemic.
At the start of this year 70,689 Mainers were enrolled in the expanded Medicaid program, according to state data.
That’s an increase of almost 26,000 since March, when the COVID-19 pandemic arrived in Maine. Given the pandemic’s widespread layoffs and job losses, which often result in a loss of health care, many Mainers would likely have gone uninsured or faced unaffordable insurance premiums if not for the expanded Medicaid program.
Medicaid expansion is a central pillar of the Affordable Care Act, but each state had to approve expansion independently. The program expands eligibility to individuals whose household income is below 138 percent of the federal poverty level ($17,609 for an individual, or $36,156 for a family of four in 2021). Maine voters approved expansion in 2017, after former Gov. Paul LePage spent years vetoing Medicaid expansion bills enacted by the Legislature. Even after voters had their say, LePage continued to block the law.
Mills made implementation one of her first official acts when she took office in January 2019.
Access to Medicaid, known here as MaineCare, has meant access to life-saving care for Mainers. Between March and November, enrollees in the expansion population received the following treatments:
- 2,101 breast cancer screenings
- 1,645 colorectal cancer screenings
- 2,001 treatments for diabetes
- 2,450 treatments for hypertension
- 13,140 mental health treatment
- 4,739 treatments for substance use disorder (including 3,001 opioid use treatments).
This critical safety net for Mainers during the pandemic has also come at a modest cost to the state. The expanded MaineCare program is on track to cost just under $500 million in state fiscal year 2021, with the vast majority of the funding coming from the federal government.
In most cases, every dollar of state money spent on expanded MaineCare is matched by nine dollars in federal funds, meaning that the total state cost for providing health care to over 70,000 Mainers is approximately $50 million per year – a little more than $700 per enrollee. The hundreds of millions in matching federal dollars help to boost Maine’s economy, too – supporting thousands of jobs at hospitals and in the communities that they serve.
The expanded MaineCare program is providing health care to Mainers during an unprecedented public health emergency — all at a very modest cost to Maine taxpayers. The success of expanded MaineCare should be an example to lawmakers as they prepare the next biennial budget – preserving safety net programs and essential services to Mainers should be a top priority.