Effects of MaineCare Gap Felt Unevenly Across the State

It’s clear that accepting federal funds to increase health coverage in Maine would be good for our economy and for our collective health. It would also help reverse a troubling trend. Maine was the only state to see the proportion of people without health insurance increase since the passage of the Affordable Care Act.

Now with the help of data from the Census Bureau’s American Community Survey (ACS), we can better understand how Maine’s failure to accept federal funds affects different parts of the state by legislative district. In general, Mainers without health insurance live outside the more prosperous I-95 and I-295 corridors. Legislative districts from Kittery to Augusta, and along the coast as far as Damariscotta, have relatively small uninsured populations (there are exceptions in poorer urban areas like parts of Portland and Lewiston). However, move further Down East —to Deer Isle or Searsport ―or further inland, to Rumford, Bethel, or Dexter and those numbers increase.

The bottom line is that rural Maine is being left behind. In some rural communities, the number of people without health insurance has doubled or even tripled between 2012 and 2014.

The increase in the number of people without health insurance in rural Maine is almost entirely the result of LePage administration policies. Early in his tenure, the governor signed off on rules that allowed insurance companies to hike rates on older and rural Mainers making health insurance even less affordable. Then the governor refused to accept federal funds to expand MaineCare which has created a coverage gap for people who are too poor to qualify for federal health insurance subsidies that would enable them to buy private insurance. He compounded this problem by reducing eligibility for MaineCare effectively dumping thousands more Mainers into the coverage gap.

The data are not all bad and provide some insight into how the ACA is helping to mitigate the impacts of LePage administration policies in more prosperous areas. Health insurance coverage has improved in some communities, especially in the coastal south, like Cape Elizabeth and Kennebunkport. That’s because federal subsidies made insurance more affordable for many middle- and lower-middle income families that couldn’t afford it before. But even in these areas, there are still people who fall into the coverage gap created by Governor LePage’s refusal to accept federal funds to expand MaineCare.

It’s not too late for legislators to overcome Governor LePage’s intransigence.  The data clearly show that people in every legislative district will continue to be hurt if they fail to do so. Furthermore, evidence is mounting from around the country affirming the positive benefits of accepting federal funds. In Maine, we know that not only would accepting federal funds help prevent cuts in services and job loss at local hospitals but it would also help create thousands of new jobs across the state. This would be welcome news, particularly in rural Maine, where the need for jobs is more pressing than ever.

Note on Data

The data used for this analysis were taken from the American Community Survey 5-year estimates for 2012 and 2014. For populations of this size, the data contain significant margins of error. Therefore, while the number of individuals and percentage of the total population within each district have been given for comparative purposes, the overall pattern is more important than the numbers themselves.  Likewise, that margin of error increases when the datasets are combined. For the change in the uninsured population from 2012-14, only those districts with statistically significant changes outside the margin of error were included.



Hover over each district for a set of figures. Use the filters on the right-hand side to switch between house and senate districts, or to search by party affiliation of the representative. In addition to the two maps, a sortable table containing the underlying data is provided.  Click on the column headers to sort the table.