When 31 states (plus the District of Columbia) have accepted federal funding to expand Medicaid, and two more states are in discussion to do so, the LePage Administration’s arguments for remaining in the shrinking minority of states stubbornly rejecting hundreds of millions of dollars in healthcare funding are wearing increasingly thin.
Without even waiting to see the content of the latest bill in the Maine legislature to propose expansion, Maine Department of Health and Human Services (DHHS) Commissioner Mary Mahew went on a preemptive media blitz to spread misinformation about the true cost of expanding Medicaid in Maine (MaineCare). Mayhew and her staff at DHHS continue to cite statistics from the notorious report from the Alexander Group, despite having terminated their contract with the report’s authors over plagiarism and inaccuracies. It’s also remarkable that DHHS should use statistics taken from the Alexander report, since these are based on assumptions that the administration’s economic policies will be such a failure that poverty in Maine will grow at an alarming rate over the next ten years. Mayhew and LePage have also taken advice from the federal Center for Medicaid Services (CMS) out of context, insisting that a large portion of new MaineCare enrollees wouldn’t be eligible for enhanced federal matching rates, when CMS has given assurances on multiple occasions that the opposite is true.
Meanwhile, in the real world, Republican Senator Tom Saviello of Wilton, unveiled the details of the latest MaineCare expansion bill, LD 633 at a press conference, accompanied by representatives of law enforcement and the health care sector. The contrast between the administration’s talking points and the experts’ testimony could not be clearer:
Mayhew: Deaths from substance abuse have not decreased in states that have expanded Medicaid; this won’t help Maine’s drug crisis.
Reality: Jack Peck, Chief of Police, Farmington: “Because of this lack of [health care coverage], we often see people we know need help but can’t stay clean, let alone out of trouble…access is critical to reducing Maine’s drug problem.”
Mayhew: Maine’s justice system won’t realize cost savings through expansion.
Reality: Joel Merry, Sagadahoc County Sheriff: “The costly in-and-out of jail cycle is caused by barriers to [medical] treatment. Sixty percent of county jail inmates suffer from substance abuse, 40 percent have mental health problems…Maine’s jails are becoming nothing more than triage centers.”
Mayhew: Those who are uninsured can go to Maine’s federally-qualified health centers for treatment. These centers receive reimbursements from the federal government.
Reality: Connie Coggins, CEO of Healthreach: “Federal [reimbursement for uninsured patients] really doesn’t cover the cost of care, or of developing the infrastructure to provide care in rural areas…we can’t [afford to] provide the range of services like substance abuse treatment.”
Dr. Leah Bauer, Medical Director, Midcoast Hospital Addiction Services Center: “I feel helpless with my uninsured patients…Sometimes treating the uninsured feels like practicing medicine in the Third World.”
Mayhew: The last time Maine expanded Medicaid, the state cut reimbursements to providers, running up a debt to hospitals over $750 million.
Reality: Jeff Austin, Maine Hospital Association: “We know the federal government’s ability to finance expansion is there, because we [Maine’s hospitals] are paying for it. Maine’s hospitals are seeing cuts to Medicare payments without the benefits of state Medicaid expansion that those cuts are supposed to pay for…The hospital financial situation is critical…We can no longer wait.”
The Maine Chiefs of Police, the Maine Sheriffs Association, the Maine Hospital Association, and numerous individual health care providers have endorsed Senator Saviello’s bill. It’s disingenuous for DHHS to imply that expanding MaineCare would not address the state’s drug abuse crisis, or that it would be a disservice to Maine’s hospitals. Using incorrect data from plagiarized reports doesn’t change the fact that MaineCare expansion is a good deal for Maine.