Currently showing posts tagged Maine healthcare

  • Maine Senate passes GOP-led Medicaid expansion bill

    The Maine Senate on Tuesday gave initial approval to a Republican-sponsored bill to accept federal dollars to expand access affordable health care for low-income Mainers.

    The bill was approved 18-17, with three Republicans joining all 15 Democrats in supporting the bill. Those Republicans were Sen. Tom Saviello, R-Wilton; Sen. Roger Katz, R-Augusta; and Sen. David Woodsome, R-North Waterboro.

    LD 633, sponsored by Sen. Saviello, would draw down major increases in federal funding to provide health insurance to nearly 80,000 Mainers. The bill would lead to influx of more than $2 billion in federal funding over the next five years, and is estimated to create 3,000 jobs.

    The bill utilizes Medicaid to provide coverage to the poorest Mainers, and private health insurance to expand access to affordable health care for other low-income residents. It requires eligible enrollees to contribute to the cost of their care, and helps unemployed Mainers find jobs. If the federal government reneges on its pledge to cover the vast majority of the cost, the bill sunsets.

    “Sen. Saviello has done his homework,” said Sen. Anne Haskell, D-Portland, the lead Senate Democrat on the Health and Human Services Committee. “This bill is different than any we’ve seen. Its various pieces are drawn from the best examples of success in other states. By taking the best there is to offer, this bill provides a responsible path forward for health care for the entire state.”

    All newly enrolled Mainers would be required to contribute to the cost of their health coverage. Those covered by Medicaid would have to pay copayments up to the level allowed by the federal government, while those enrolled through the marketplace would be required to pay up to 5 percent of their incomes for premiums, copayments and deductibles. The bill also includes provisions to connect newly covered unemployed Mainers to job referrals through the Department of Labor.

    If enacted, the bill would see Maine join 31 other states that have accepted available federal health care funds to support health care. Notably, other states have seen tremendous savings to their correctional systems by providing coverage for addiction and mental health treatment. LD 633 has the endorsement of the Maine Police Chiefs and Maine Sheriffs associations.

    “This money will provide budget relief to our communities, where criminal justice and correctional systems have become de facto drug treatment and mental health care centers for the uninsured,” said Sen. Bill Diamond, D-Windham. “States like Ohio, Kentucky, Illinois and Washington are all seeing millions of dollars in savings to their criminal justice and corrections system. Like them, Maine can better provide for our criminal justice and health care systems if we pass this bill.”

    The bill faces additional votes in the House and Senate.

  • Rep. Longstaff sponsors law to help breast cancer patients receive care in Maine

    by Ramona du Houx

    Before Lee Lyford of Waterville underwent breast cancer surgery last year, her insurance company told her a 24-hour or more post-operative stay in the hospital was not medically necessary and refused to authorize a longer stay.

    At Lyford’s insistence and after the procedure, her insurance agreed to cover her full hospital stay following the double mastectomy, but her experience reminded her of stories about other women who were sent home less than 24 hours after surgeries because their insurance companies were reluctant to cover longer stays.

    At a public hearing at the State House Thursday, Lyford thanked Rep. Thomas Longstaff, D-Waterville, for sponsoring a measure to prevent others from being sent home prematurely by ensuring breast cancer patients and their doctors, rather than insurance companies, determine the length of their hospital stays.

    Longstaff’s bill, LD 359, would help breast cancer patients by requiring insurance policies to cover hospital stays of at least 48 hours for patients undergoing a mastectomy or lumpectomy.  Currently, he said, breast cancer patients’ stays are sometimes cut short because of what insurance companies decide to cover.

    “Particularly for such an important and invasive procedure as a mastectomy, the length of hospital stay should be determined by the patient and her doctor,” said Longstaff.  “Unfortunately, even when both agree that a longer hospital stay is medically appropriate, some patients’ stays are shortened because the insurance provider is reluctant to cover an overnight stay.”

    The bill would also require health insurance policies to cover no less than a 24-hour stay following a lymph node dissection, another procedure to treat breast cancer.

    Longstaff’s bill would add Maine to the at least 21 states that currently address the problem of so called “drive-through mastectomies” with laws requiring a minimum period of inpatient coverage following a mastectomy.

    “The 48 hours after surgery are when complications such as bleeding and infection are most likely to occur.  The decision as to whether a patient needs to stay in the hospital is best made by the physician based on his or her professional judgement and in response to the individual patient’s condition,” said Lyford testified before the Insurance and Financial Services Committee.  “It is not a decision that should be made ahead of time by an insurance representative.”

    Hilary Schneider, director of governmental relations in Maine for the American Cancer Society’s Cancer Action Network, also testified in support of the bill.

    “A decision about when a patient is ready to leave the hospital after cancer surgery is one that is best left to a doctor and the patient,” said Schneider. 

    Local lawmakers Reps. Catherine Nadeau, D-Winslow, and Henry Beck, D-Waterville, are cosponsors of the measure.

    “No breast cancer patient should be forced to return home prematurely simply because her insurance provider won’t cover her as an inpatient,” said Nadeau, who is a surgical technician by training and has extensive experience in health care.  “Health care professionals and their patients, not insurance companies, should make these decisions.”

    According to the Maine Center for Disease Control, breast cancer is the second leading cause of cancer-related death among U.S. women. 

    The Insurance and Financial Services Committee will hold a work session on the measure in the coming weeks before making a recommendation to the full Legislature.

    Longstaff is serving his third term in the Maine House.  He is a member of the Veterans and Legal Affairs Committee and represents part of Waterville.