Maine has a chance to correct injustice by expanding health care to New Mainers with low incomes

All Mainers — no matter where they come from or what they look like — deserve access to affordable health care.

MaineCare offers affordable health care coverage to those who would otherwise struggle to afford it. But since 2011, Maine has unjustly excluded hundreds of New Mainers from this program. This year, lawmakers can correct this injustice and continue the path toward ensuring everyone in our state has access to health care.

LD 718, “An Act to Improve the Health of Maine Residents by Closing Coverage Gaps in the MaineCare Program and Children’s Health Insurance Program,” sponsored by Assistant House Majority Leader Rep. Rachel Talbot Ross, would restore MaineCare eligibility for hundreds of New Mainers with low incomes, such as people waiting for decisions on asylum cases and new green card holders.1

Mainers in those situations were eligible for MaineCare until 2011, when the LePage administration reversed a decades-old policy and denied health care to this group. Before these New Mainers’ eligibility was unnecessarily restricted, some 500 Mainers received health care coverage under this policy. This bill is expected to restore coverage to a similar number of individuals, though the final number may be slightly higher because Medicaid expansion has increased eligibility in the MaineCare program and because Maine’s immigrant population has increased since 2011.

We’ve all spent the past year living through a public health crisis, a global pandemic that has starkly illustrated how closely our own health is dependent on the health of others. The COVID-19 pandemic has shown clearly that public health relies on the ability of all Mainers to access affordable care in a timely manner. Thankfully, the Legislature took steps to ensure that all Mainers could access COVID-19 testing and vaccinations at no out-of-pocket cost.

But expanding and guaranteeing access to health care doesn’t only help us during a pandemic; We’re all better off by ensuring that vulnerable New Mainers can afford to see a doctor, buy prescription medicines, and get the treatment they need.

Medicaid coverage comes with a huge number of benefits. These include greater access to health care, from preventative medicine to treatment for chronic diseases. Newly covered individuals also report themselves to be in better overall health. Effects go beyond health outcomes, however. Medicaid access has also been shown to reduce poverty and provide more economic stability. Access to health care means less hunger, fewer evictions, and better credit scores as individuals’ pocketbooks are no longer squeezed by medical costs.2

LD 718 would have similarly positive impacts on New Mainers’ health and economic wellbeing. When all Mainers have the ability to thrive, our overall economy is stronger. Mainers have more money to spend at local businesses, and their improved health allows them to be more productive.

The status quo leaves many New Mainers with few options. Low incomes mean these New Mainers and their families almost certainly cannot afford to purchase commercial insurance. Charity care provides a safety net of last resort, but does not provide preventative care, medical devices, or prescriptions. LD 718 would offer comprehensive health care options to these Mainers.

LD 718 would bring benefits across generations. Research shows that even when children are eligible for Medicaid coverage (as natural-born citizen children born to ineligible immigrant parents, for example), they are much less likely to be enrolled for coverage if their parents are ineligible. Making sure that every member of a family can receive affordable care is the best way to ensure that everyone who needs care has access.3

Lastly, coverage under the MaineCare program will reduce costs for hospitals, just as Medicaid expansion has improved hospital balance sheets.

LD 718 will not only address a moral failing in Maine’s current law. It will provide tangible benefits to our economy and society.  In addition to improving the health of our friends and neighbors, it will improve public health, bolster hospitals’ financials, and strengthen our economy with a more productive workforce. Lawmakers should approve it.


Notes

[1] Refugees and asylees can enroll in Medicaid once their status has been confirmed. Other immigrants become eligible five years after receiving permanent resident status.

[2] Guth, Madeline, Rachel Garfield, and Robin Rudowitz. “The Effects Medicaid Expansion under the ACA: Updated Findings from a Literature Review,” Kaiser Family Foundation, Mar 27, 2020. https://www.kff.org/medicaid/report/the-effects-of-medicaid-expansion-under-the-aca-updated-findings-from-a-literature-review/

[3] Schubel, Jessica. “Expanding Medicaid for Parents Improves Coverage and Health for Both Parents and Children,” Center on Budget and Policy Priorities, Oct 21, 2020. https://www.cbpp.org/research/health/expanding-medicaid-for-parents-improves-coverage-and-health-for-both-parents-and