A large majority of Mainers have made it clear that they want Medicaid expanded; they voted 59 percent to 41 percent in favor of it in last fall’s referendum. The Maine Legislature approved it five times, but five times Governor LePage vetoed it. And once again the Governor is making clear his intentions to do what he can to prevent expansion.
There are two arguments generally made against Medicaid expansion in Maine, and the Governor is claiming both. One is that the state can’t afford it. Yes, it will cost the state money, but when LePage says $100 million a year, he is grossly exaggerating. By fiscal year 2021, Maine’s share of expanded Medicaid costs is likely to be about $82 million. However, the state will have to pay $27 million less from its General Fund for mental health and substance abuse services that will be covered under expanded Medicaid, reducing the state’s net cost to $55 million. Compare this to the $531 million in federal funds that expanding Medicaid will bring into the state that year. This money will generate some 6,000 jobs, primarily in the health care sector and generally paying higher than average wages. Expanding Medicaid also will reduce uncompensated hospital care, pumping much needed funds into rural hospitals that are struggling to stay afloat.
Le Page’s other argument is that 70,000-80,000 “able-bodied adults” will be getting health insurance for nothing, with a clear implication that they aren’t working and don’t deserve it. The reality is this. Medicaid expansion would provide insurance to all adults in Maine who earn less than 138 percent of the federal poverty level and are not currently covered by traditional Medicaid. Many, if not most of these people are employed. Most of them, however, are working jobs that either don’t offer health insurance or offer insurance that these employees can’t afford. Nor can they afford individual plans under the Affordable Care Act because premium subsidies are only available to people earning more than 138 percent of the federal poverty level. Furthermore, many of these people have chronic health conditions for which they are not receiving care because they can’t afford it, conditions that often make it impossible for them to work full time or in more demanding, higher paying positions.
Thirty-one other states (many with Republican governors) have expanded Medicaid, extending health insurance to millions of their citizens and bringing billions of federal dollars into their states. Not one has reversed that determination; not one has decided that it can’t afford it or that those newly insured don’t deserve it. It is time Maine joined them. It is the right thing to do, and from an economic standpoint, it is the smart thing to do.
I encourage readers to ask their state legislators to support timely implementation of Medicaid expansion and to keep Governor LePage from obstructing it.