A Divide and Conquer Strategy that Risks the Health of Maine’s Seniors and Working Poor

The classic “divide and conquer” strategy,  often attributed to cunning Julius Caesar, operates on the premise that pitting your adversaries against each other before you strike  is one sure path to victory. In a recent press release heralding $25.4 million in excess MaineCare funds now available to shore up struggling nursing homes, the LePage Administration appears to be following Caesar’s formula.

This funding is great news for nursing homes in Maine – especially in rural areas where many are struggling badly. But the timing and explanation for the sudden availability of the money raise a lot of questions.

Last November, Health and Human Services Commissioner Mary Mayhew shocked the legislature by announcing that Medicaid faced a $100 million shortfall.  But in June, the commissioner unexpectedly heralded a $4.6 million surplus fortuitously available to leverage another $8.5 million in federal funds for besieged nursing homes. The governor’s office claim that his repeated vetoes of accepting federal funds to expand Medicaid to 70,000 uninsured Mainers “have been key factors in freeing up funds for nursing facilities” is a political move worthy of  wily Caesar.

The release argues that the only way to pay for nursing homes is by denying low-income working Mainers health coverage. But this is a false choice that clearly pits the interest of two vulnerable constituencies- aging Mainers and the working poor –against one another.

In fact, federal law forbids the state from using funds appropriated  to expand coverage to the uninsured- the funds the governor cites -to pay for anything else. Maine- the only state in New England to refuse the funds- continues to lose almost $1 million in healthcare dollars every day.   In the meantime, the federal government has paid 100% of the costs of coverage in the states that expanded Medicaid – just as promised.

Maine’s nursing homes have been struggling for years. Perhaps the most heart-wrenching case was the 2012 closing of Atlantic Rehabilitation and Nursing Center in Calais, The closure displaced elderly residents to Ellsworth 100 miles from their homes, and put almost 100 local workers out of a job.  The governor failed to act then, even after 1,800 residents petitioned him to reconsider Commissioner Mayhew’s authorization of the closure. This spring, many more nursing homes have been open about their financial struggles.

There’s more backstory to this press release. In 2011, the governor proposed to pay for $60 million in tax cuts for the wealthy via cuts to reimbursements to assisted living facilities caring for seniors. This year, in response to the Calais nursing home closing, Senator Margaret Craven of Androscoggin sponsored a bill allocating additional funding to nursing homes. This bill became law without the governor’s signature.

The governor may be following a familiar political strategy when he makes the false claim that health care for the working poor will come at the expense of health care for Maine seniors. But in this game of divide and conquer, the losers are the Maine seniors and working poor whose access to quality, affordable health care are put at risk.

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