To the editor:
In 2010, the Affordable Care Act (Obamacare) became law. A critical provision of the ACA was the expansion of Medicaid, known in Maine as MaineCare. The intent of expansion is to extend coverage to include eligible low-income Mainers whose incomes are too high to qualify for existing MaineCare, but who do not qualify for federal tax credits to purchase insurance on the ACA marketplaces.
A 2012 Supreme Court decision gave the states the right to decide whether to accept federal funds to implement expanded Medicaid coverage. Thirty-one states have chosen to do so. Seventeen of those states have Republican governors. One of them, John Kasich, of Ohio, has said, “If they don’t get coverage, they end up in the emergency room, they end up sicker, more expensive. I mean, we pay one way or another … and so, this has been a good thing for Ohio.” Since implementing Medicaid expansion, Ohio’s uninsured rate has fallen from 15 percent in 2012 to 6.5 now.
Maine is the only New England state that has not accepted expansion, although our Legislature has voted five times, with support from both parties, to accept it. The governor has vetoed all those votes, thus denying Maine $1.2 billion over the last few years. Without his veto, Maine would have received $500 million this year. To be clear, this is our money that is being left on the table.
Since Question 2 is a citizen’s initiative, it cannot be vetoed by the governor.
Approval of Question 2 on the Nov. 7 ballot will give 70,000 currently uninsured low-income Mainers access to health care coverage. To be eligible, household income has to be at or below 138 percent of the federal poverty level. This year, for example, an individual with income below $16,643 and a family of four with household income at or below $33,924 would qualify.
Most of those who would be eligible are currently working in low-wage jobs that don’t offer health insurance, or if it is offered, it costs more than the employee can afford. Among those who would benefit are the self-employed, construction workers, health care workers, food service workers, and child care providers. With expansion there would be increased resources for mental health care services and drug abuse treatment. Around 3,000 veterans and 1,000 of their family members would also benefit. For a number of reasons, veterans have a higher rate of homelessness than the overall population. In states that have expanded Medicaid, veterans’ access to health care has resulted in significantly better outcomes. And expansion would increase health care access for pregnant women, mothers, and the 12,000 Maine children who are not insured.
Expansion will create at least 4,000 new jobs across the state, including in our rural areas.
In 2016, half of Maine’s hospitals ran an operating deficit. Two-thirds had only one month’s cash on hand. With expansion, hospitals and health centers would see increased revenue and fewer uninsured patients. Medicaid expansion states have seen a 40 percent reduction in uncompensated care. Expansion protects all of us from the fact that struggling hospitals will have to cut back staff and services, or even close.
And for many of us, a major illness could result in bankruptcy, loss of our homes, and loss of our ability to work.
Medicaid expansion is strongly endorsed by the Maine Hospital Association, The Maine Medical Association, the American Nurses’ Association, and many members of the Maine Small Business Coalition.
I believe that the healthier we all are, the more we all will benefit.